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Jason Rinehart presented to the emergency department (ED) of Akron General Medical Center with nausea, vomiting, and back pain.1 No definitive diagnosis was made, and the patient was discharged with medications to control his symptoms. He died hours after discharge, and an autopsy revealed an aortic dissection as the cause of death.
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Some EDs have adopted the practice of documenting overcrowding, either
by flagging patient charts or electronically recording the
information with software, to pinpoint exactly how busy—and
possibly, how understaffed—the department was on a given time
and day. But is this going to help or hurt the ED physician in the
event of a malpractice lawsuit?
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Dr. Janiak has served as an emergency medicine medico-legal consultant for over 30 years, and has reviewed hundreds of malpractice cases. In the process, he has recognized common patterns and mistakes that emergency physicians make that set them up to be sued. This article takes a tongue-in-cheek approach to pointing out potential mistakes and ways that lawsuits might be avoided.
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Being served with papers indicating a patient has sued you is a
shocking and upsetting moment. However, this doesn't necessarily mean
the case is valid—or even that it will go forward at all.
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Post-extubation laryngeal edema, although infrequent, can necessitate reintubation and lead to other complications.
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Despite concerns that recombinant human Activated Protein C (rhAPC) is associated with an increased risk of bleeding, the FDA failed to list several of the bleeding-related exclusion criteria used in the PROWESS trial as contraindications to use of this agent.
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Pulmonary hypertension (ph) is common among patients in the intensive care unit (ICU). In fact, many ICU clinicians simply view PH the same way they view leukocytosis as an expected finding caused by the "bigger problems" of sepsis, respiratory failure, congestive heart failure, volume overload, and myocardial infarction.
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This study from the University of Toronto sought to quantify the number of individual pieces of clinical information entered into the medical record on each patient in the ICU each day.
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