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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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Small studies with older equipment at single centers have shown that coronary CT angiography (CTA) is promising for evaluating coronary anatomy. New 64-slice CT scanners have improved spatial and temporal resolution. Thus, these investigators from the Netherlands conducted a prospective, multi-centered, multi-vendor study to assess the accuracy of 64-slice CTA for in dentifying significant coronary artery disease (CAD) in symptomatic patients undergoing conventional coronary angiography (CCA).
