"Why didn't my grandmother see a neurologist immediately in the ED?" is a question that may arise in the event of a malpractice lawsuit involving stroke care.
Most emergency physicians will be sued during their career. Lawsuits can lead to interpersonal difficulties, loss of job satisfaction, and emotional distress. An understanding of the malpractice process and ways to reduce risk can help emergency physicians deal with this ever present threat.
If you aren't going to give tPA and would like to avoid a lawsuit, you'll want to be very clear in your documentation as to why the patient didn't meet treatment criteria. "And if you do give it, you should be very clear why the patient did meet the criteria," says John Burton, MD, chair of the Department of Emergency Medicine at Carilion Clinic in Roanoke, VA.
Although some ED physicians remain opposed to the idea of using tPA, the consideration of the use of thrombolytics such as tPA for stroke patients who are eligible candidates has become the public expectation
