ED Legal Letter – January 1, 2018
January 1, 2018
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The Opioid Minefield
The opioid epidemic has become not only a public health crisis, but also a political one. Legislative activity at the state and federal levels of government has reached a fever pitch, the ramifications of which certainly will affect the practice of emergency medicine.
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ED-based EHR Errors Caused More Significant Harm to Patients Compared to Other Settings
Seeking to obtain more information on health IT-related problems, researchers analyzed EHR-related cases occurring between 2011 and 2015. They found 420 cases in which the EHR was a contributing factor. Of this group, 50 cases occurred in the ED.
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Liability for EP if Admitted Patient’s Condition Deteriorated
EPs are not absolved of legal responsibility for admitted patients who remain in the ED while waiting for an inpatient bed to become available. Juries rely on documentation to determine what information was communicated to the admitting physician. Providing treatment to admitted patients can lead to the EP being held to a higher standard of care. Undocumented interactions are problematic for the defense.
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Psych Patients Elope or Are Discharged? Either Way, It’s a Wrongful Death Lawsuit
If psychiatric patients are discharged or elope from the ED and harm themselves or others, a wrongful death lawsuit is possible. To reduce risks, EPs can document that there was no evidence of homicidal or suicidal ideation at the time of the ED visit, contact a psychiatrist to support the decision to discharge, keep the patient secure until the evaluation is complete, and take reasonable precautions when patients are transported to another facility.
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Did ED Patient Threaten Violence? EP Might Have Legal Duty to Warn
EPs might have a legal “duty to warn” individuals if a patient threatens violence against them, depending on their state statute. EPs are shielded from allegations of breach of confidentiality if they warn someone of a threat. Importantly, EPs can be held liable if their failure to warn leads to a violent act.