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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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Dr. Janiak has served as an emergency medicine medico-legal consultant for over 30 years, and has reviewed hundreds of malpractice cases. In the process, he has recognized common patterns and mistakes that emergency physicians make that set them up to be sued. This article takes a tongue-in-cheek approach to pointing out potential mistakes and ways that lawsuits might be avoided.
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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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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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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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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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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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Many ED physicians do not get blood alcohol levels on intoxicated patients because levels do not correlate well with the patient's mental status or competence, while others say this practice is legally risky. So should blood alcohol levels be obtained?
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Imagine being held legally responsible for everything that goes wrong during your shift—whether you were involved or not. Under the "captain of the ship" legal doctrine, could this be a legal reality? Not likely, according to experts in emergency medicine litigation.
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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.
