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This story concludes a two-part series on liability risks of boarding admitted patients in the ED. This month, we report on the problem of EDs providing an unequal level of care compared to what patients would have gotten on inpatient units.
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In a series of questionable decisions, a California federal court allowed a plaintiff to bring a "failure-to-screen" claim under the federal Emergency Medical Treatment and Active Labor Act (EMTALA) against a hospital for what was really an ordinary state malpractice claim for "failure to diagnose," and then held that California's $250,000 damages cap wouldn't apply because the EMTALA claim was not a "professional negligence" claim as contemplated by the state's tort reform law - the Medical Injury Compensation Reform Act (MICRA).
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The dangers of sleep deprivation and fatigue can no longer be ignored.
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One after the other, videotapes on primetime news showed a patient, Esmin Green, being ignored by ED staff as she lay dying on a waiting room floor in a Brooklyn psychiatric hospital after waiting almost 24 hours for a bed. What impact will this "horror story" case, and others like it, have on ED litigation?
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A patient, Scruggs, presented to Danville (VA) Regional Medical Center (DRMC) ED about 2 a.m. complaining of two days of prolonged dry heaves. He was triaged in the usual manner, prioritized as "non-urgent," and instructed to wait in the waiting area until his name was called. The court pointedly noted that the triage nurse failed to document the patient's "diabetic ketoacidosis condition or his history of diabetes."
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Many hospitals have been cited by the Centers for Medicare & Medicaid (CMS) for failure to provide an appropriate medical screening examination for mental health patients, or for discharging these patients in an unstabilized emergency medical condition, notes Barbara E. Person, JD, an attorney at the Omaha, NE-based law firm Baird Holm.
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"Quit dreaming that your patients are being watched by physicians in the ED." That's what the vice chairman of the Department of Emergency Medicine at State University of New York at Stony Brook told physicians when he sought buy-in for a process to move patients boarded in the ED upstairs during high capacity.
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Managing a patient's compromised airway involves preparing for the possibility of not being able to complete the intubation procedure in a timely manner. To avoid ongoing hypoxia and hypercapnea, management should include being ready to use alternative or "rescue" methods, including a surgical airway.
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This story is Part 1 of a two-part series on liability risks of boarding admitted patients in the ED. This month, we'll report on liability risks of holding admitted patients in ED hallways.
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You find yourself wrestling with an uncooperative, intoxicated trauma patient who removes his own cervical collar. It's easy to see that this scenario is fraught with legal risks, but what is the right thing to do in this kind of situation?
