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Most emergency physicians (EPs) would never consider leaving a patients chart completely blank, as theyre well aware of the resulting liability risks, but caring for an ED colleague without documentation is no different, according to Martin Ogle, MD, FACEP, senior partner and vice president of CEP America, an Emeryville, CA-based provider of acute care staffing solutions.
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Is a parent refusing recommended care for a minor patient in the ED?
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Was a patient transferred without being intubated first because the emergency physician (EP) wasnt comfortable managing a difficult airway?
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Informed refusal is the antithesis of informed consent, a natural extension of the doctrine. Informed consent is discussed in great detail in the medical, legal, and risk-management literature; whereas informed refusal has received less attention.
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If a patient deteriorates because of a transport and later sues, concerns will inevitably arise that the emergency physician (EP) didnt stabilize the patient prior to transport, or that the patient should not have been transferred, says John Tafuri, MD, FAAEM, regional director of TeamHealth Cleveland (OH) Clinic and chief of staff at Fairview Hospital, also in Cleveland.
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Two days after bombs went off near the finish line at the Boston Marathon, another horrific disaster rocked the tiny community of West, TX. In that incident, a reported fire at a fertilizer plant was followed by a huge explosion that leveled four blocks of the city. The blast killed 14 people, most of whom were emergency responders, and injured more than 200 others.
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Fortunately, terrorist attacks are not a common occurrence in America. But ever since the World Trade Center towers were struck down by extremists in September 2001 in New York City, hospitals around the country have been honing the way they drill so that they will not be caught off guard in the unlikely event that a terrorist act triggers mass casualties in their region.
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The Centers for Disease Control (CDC) in Atlanta, GA, reports that every year more than 130,000 children younger than the age of 13 are rushed to the ED for treatment following motor vehicle accidents on the nations roadways.
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The fast pace of a busy ED can make it difficult to focus in on processes that could be improved, but leadership and commitment can move the needle in the right direction as long as emergency personnel understand why change is important.
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Was a frequent ED patient discharged after complaining of chest pain, and later suffered a myocardial infarction (MI)? In this scenario, the emergency physician (EP) can expect a lawsuit if she sent the patient home without assessing and treating the patient as she would any other patient with the same complaint, says Jonathan T. Brollier, JD, an attorney at Bricker & Eckler in Columbus, OH.