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Entrapments and retained foreign bodies represent a common cause of emergency department (ED) visits. A majority of these pediatric presentations are easily assessed and managed by emergency physicians. However, even when accurately identified, this injury pattern may present therapeutic challenges.
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Over the years, emergency medicine physicians and pediatricians have been sued many times for failure to recognize and report non-accidental trauma and vulnerable children. Unfortunately, there are a number of ways to go wrong when it comes to reporting child abuse, and there are three recognized liability issues: A liability for failure to report suspected abuse, liability for reporting suspected abuse and liability for unauthorized release of confidential information during the course of reporting.
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Use of excessive force. Misapplication of restraints. Failing to follow standards from the Centers for Medicare & Medicaid Services (CMS) or The Joint Commission. Any of these practices can result in a liability claim from an ED patient for injuries arising from restraint.
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Long ago, one of my mentors staunchly opined that "only a 'real doctor' should be allowed to testify that a 'real doctor' breached the standard of care." Two recent high-level court decisions upholding tort state reforms bring us closer to that reality, i.e., requiring the plaintiff's physician expert to actually practice medicine in order to testify in a medical malpractice lawsuit.
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This is the first of a two-part series on missed myocardial infarction [MI] cases. This month, we report on the best practices for reducing liability risks involving triage, and review cases of chest pain patients involving adverse outcomes in ED waiting rooms.
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"Unfortunately, while health care access continues to decline, the episodes of bad outcomes in waiting rooms can only rise.
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Methicillin-resistant Staphylococcus aureus (MRSA) has reached almost mythic status. It has come to mean much more than an isolate of S. aureus that happens to be resistant to methicillin, an antibiotic that is no longer in clinical use. It is a slap in the face of humankind's efforts to rein in infectious illness.
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