Emergency Department Management & Law
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Failure to diagnose infection causes toddler death and yields verdict of $1.72 million
Plaintiffs’ 3-month-old daughter was taken to the hospital with a high fever and elevated pulse rate. The ED physician diagnosed an ear infection and discharged the infant with a prescription for antibiotics. Days later she was diagnosed with pneumococcal meningitis, hypoxic brain injury, and hydrocephalus. She lived for 20 more months. Plaintiffs sued the hospital and the ED physician, and they won a verdict of joint and several liability for $1.7 million.
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Missing Documentation on Evolving High-risk Conditions? It Will Complicate Defense of Medical/Malpractice Suit
Lack of documentation on patients with high-risk-conditions often results in the settlement of otherwise defensible claims against emergency physicians (EPs), according to Douglas Segan, MD, JD, FACEP, a medical-legal consultant based in Woodmere, NY.
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Warning: ED Peer Review Materials Aren’t Always Protected from Discovery
Many emergency physicians (EPs) assume that all aspects of the peer review or quality improvement processes involving emergency department (ED) care are automatically protected from discovery during malpractice litigation. This is not necessarily the case.
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Here Are Plaintiff Attorneys’ Toughest Deposition Questions for Emergency Physicians
Did an emergency physician (EP) come off poorly during a deposition, volunteer some damaging information, or inadvertently complicate the defense of a co-defendant? If so, “it will significantly change the perspective of the defense attorney, the hospital, or the insurance company on whether the case should settle and for how much, in a way that’s going to be adverse to the EP,” warns John Burton, MD, chair of the Department of Emergency Medicine at Carilion Clinic in Roanoke, VA.
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Nursing Notes Can Become Unexpected Problem for EP During Med/Mal Litigation
A triage nurse’s note stating that a patient had fever and hip pain in his prosthetic hip became a key area of focus during a recent malpractice trial. At deposition and at trial, the emergency physician (EP) claimed to have examined the hip, and found that the patient did not have increased pain with range of motion.
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Use these practices to treat ED patients using "meth"
If the patient standing in front of you appears jittery, unable to sit still, and is continually scratching at sores on his or her face and body, it's likely he or she is using methamphetamine. "It's unfortunate to say, but we can usually tell by looking at someone that he or she is a meth user," says Sue Williams, RN, a nurse with SSM Behavioral Health Services at St. Joseph Health Center-Wentzville in Wentzville, MO. -
Pediatric Corner: Identify signs of dangerous pediatric airway problems
Children are more susceptible to acute airway compromise due to the unique characteristics of a child's airway, according to Eileen Callahan, RN, BSN, an ED pediatric nurse educator at Tufts Medical Center and the Floating Hospital for Children in Boston, MA. -
Get stroke patients CT scans more quickly
Every part of the process in stroke care from the time the patient begins to have symptoms to the time treatment is initiated is constantly examined for ways to cut minutes, reports Sharon Pulver, MSN, RN, CEN, network stroke coordinator for the SSM Neurosciences Institute in St. Louis, MO. -
Prevent infections caused by contaminated ED equipment
If a tuberculosis patient just left your ED to go to a negative pressure room, housekeeping must come and disinfect the room wearing full contact precautions garb, leave the room unused for four hours, and remove all hanging curtains and replace these with clean ones. -
Could a suicidal patient be discharged from ED?
While assessing a 40-year-old male who complained of abdominal pain, nurses did a routine mental health screening, which included asking if he was currently suicidal. "He answered 'yes' to all of the questions," says MaryEllen Swanson, RN, a senior staff nurse in the ED at Hennepin County Medical Center in Minneapolis. "It would have been missed if the screening had not been done."