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Public health officials from the California Department of Health Services have recognized epidemics of three types of Clostridium-associated diseases: wound botulism, necrotizing soft-tissue infections, and tetanus. These emerging infections and intoxications have been associated with the use of contaminated black tar heroin, an association known as "the clostridial connection."
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New drugs are constantly added to the market, many of them legal. Many new drugs with abuse potential are often called “legal highs,” as they are not banned by the federal government or states. Also, products may be labeled “not for human consumption” to avoid the label of illegal. The European Monitoring Center for Drugs and Addiction Europol says 41 new drugs entered the market in 2010. The legal status of the more familiar recreational substances has encouraged users to seek newer options that offer the advantages of being legal, less expensive, less contaminated with adulterants, more readily available, or with more desirable pharmacological effects.
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The fact that an expert witness recently prevailed after suing a specialty society for suspending him for allegedly giving improper testimony in a medical negligence case wont affect the ability of the American College of Emergency Physicians (ACEP) to discipline unethical expert witnesses, according to Louise B. Andrew, MD, litigation stress counselor, founder and principal of www.MDMentor.com, and former chair of ACEPs Professional Liability Task Force Expert Witness subcommittee.
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An expert witness for the plaintiff takes the stand and proceeds to tell the jury patently false statements regarding the standard of care. While this problem is certainly not unique to emergency medicine, it is exacerbated by the number of experts allowed by judges to testify based on limited exposure to emergency medicine, who are not themselves emergency physicians, says Hugh F. Hill III, MD, JD, FACEP, an assistant professor in the School of Medicine at Johns Hopkins University in Baltimore, MD.
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If an ED claims to have certain services available, that creates a duty to provide them, according to Douglas S. Diekema, MD, MPH, an attending physician in the ED at Seattle Childrens Hospital and director of education for the Treuman Katz Center for Pediatric Bioethics at Seattle (WA) Childrens Research Institute.
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Can the ED attending physician be held liable for a patients bad outcome even if he or she never saw the patient? In almost all cases, the answer is yes, at least to some degree, according to Kevin Klauer, DO, EJD, chief medical officer for Emergency Medicine Physicians in Canton, OH, and a member of the board of directors at Physicians Specialty Limited Risk Retention Group.
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Your hospitals public relations staff may jump at the chance to advertise that patients can expect to see a doctor within 30 minutes in your ED, but claims such as this could easily backfire if a lawsuit involves this issue.
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In one case that was eventually settled, an on-call specialist admitted making no effort to come in promptly, stating that traffic would be untenable for an hour because it was near the end of a Chicago Bulls playoff, recalls Tom Scaletta, MD, FAAEM, chair of the ED at Edward Hospital in Naperville, IL, and the emergency physician (EP) quoted the specialist verbatim to make it clear why a transfer was initiated.
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A plaintiffs attorney in a missed myocardial infarction case showed the jury an EMR entry indicating the patients heart rate was within normal limits, as well as vital signs taken by a nurses assistant showing severe tachycardia.
