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Historically, ED Legal Letter has evaluated the mistakes of physicians after the fact. The diagnosis has been missed, the case has been litigated and decided. The benefit of hindsight provides an essential learning and risk management opportunity for the reader. This months issue will evaluate the thinking and behavior of physicians that lead to errors in diagnosis. An analysis of the cognitive errors in the ED by physicians will provide reflection on future premature or inaccurate diagnosis in the ED. This issue will allow physicians to recognize that certain types of thinking and behavior can be harmful to the patient. Acknowledging these faults will reduce bad outcomes and prevent future litigation.
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Emergency practitioners must be well versed in the management of diabetic emergencies. New-onset diabetes discovered on presentation to the emergency department (ED) is not an infrequent occurrence.
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Trepidation about litigation among emergency practitioners is a significant concern. Every patient encounter presents the chance for an adverse outcome. The standard of care is defined by experts as a well-established, set path with only one logical approach and outcome; in reality, the standard of care may be a tortuous path with many choices that may lead to dissimilar conclusions. This issue of ED Legal Letter outlines the problems with determining the standard of care and how courts will interpret the standard of care.
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This article completes a four-part series on abdominal pain that began with the January issue of ED Legal Letter. The first two parts outlined risk management strategies for dealing with adult abdominal pain. The third part detailed obstetric emergencies and the difficulty in caring for both mother and unborn child. This concluding segment will review the evaluation and management of pediatric abdominal pain.
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Medication errors have been publicized as among the most dangerous risks to emergency department and hospitalized patients. Newspaper and magazine articles have leaped on the issue. While physicians and hospitals would like to believe this is just news propaganda to increase sales, they are wrong. Studies have shown that patients are dying from preventable adverse drug events (ADEs). Although hospitals, physicians, nurses, risk managers, and pharmacists have made attempts to reduce risks and prevent ADEs, there is much more that must be done. This months ED Legal Letter describes different types of ADEs and develops risk management strategies to reduce the chance of medication error. Adopting the guidelines provided in this issue will create a safer environment for our patients.
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The skyrocketing cost of medical malpractice insurance has affected physicians throughout the nation. Many emergency physicians (EPs) have seen the costs of insurance nearly double in the past three years. Some insurers have deemed EPs with three claims against them in a five-year period as uninsurable. This months ED Legal Letter will provide insight into the malpractice crisis by looking at the cause, effect, and potential solutions to the problem. Furthermore, it will review why past legislative attempts to remedy previous malpractice crises have failed.
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An ED physician, like any health care provider, can be sued for wrongful death whenever there is evidence that medical malpractice has caused a patient's death.
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If highly religious nurses or physicians feel that it is appropriate to pray with patients and to share their faith, some patients will appreciate this while others may not. However, it's unlikely this practice will lead to a lawsuit.
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If a bad outcome occurs with a boarded patient, what standard of care will the ED be held to?
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Did a "boarded" ED patient have a bad outcome that can be in any way associated with a delay in diagnosis or treatment, or a failure to properly observe?
