ED Legal Letter – June 1, 2019
June 1, 2019
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Most-Often Missed Serious Neuro Conditions: Ischemic Stroke and Intraspinal Abscess
The authors of most studies on diagnostic error in the ED use a “look back” approach. Researchers start with the misdiagnosis, then examine the factors associated with it. Other investigators recently used a different method.
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Patients’ Insurance Status Affects ED Disposition
Repeatedly discharging or transferring patients with certain conditions that are more prevalent in low-income patients may draw the wrong kind of attention from federal and state regulators. However, plaintiff attorneys probably would face an uphill battle trying to establish this kind of pattern in an ED.
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With or Without Gag Clauses, It Is a Hurdle for ED Defendants to Blame EHR
Are EPs well-aware of a glitch within the electronic health record (EHR) that has almost harmed many patients? They might be wary of calling attention to it publicly due to vendor “gag clauses.” Proposed rules would eliminate gag clauses in EHR vendor contracts to encourage airing of safety concerns.
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Liability Exposure if Communication Is Poor Between ED and Consultant
When EPs and consultants are codefendants in malpractice claims, finger-pointing is sure to follow. The EP insists the urgency of the situation was totally clear; the consultant claims the whole story was not told.
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Policies Can Quickly Complicate Defense of ED Claim
Does an ED clinical policy state that all chest pain patients must undergo an ECG within 10 minutes of arrival, but it took somewhat longer? The slight delay might have had nothing to do with the plaintiff’s terrible outcome. But that does not matter; plaintiff attorneys can use it to paint a picture of substandard care.
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Legal Problems if ED Overlooks Critical Lab Finding
Critical lab results are missed because ED patients are discharged already. Other times, results are never communicated to the EP who is caring for the patient. Despite the importance of critical values in ED care and requirements that hospitals provide for the identification and timely communication of critical results, there is little standardization of procedures.
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Facial Trauma Lawsuits: Half of Cases Involve Delayed or Missed Diagnosis
Lawsuits stemmed from a variety of issues, but when EPs were sued, it was usually for failure to diagnose a fracture.
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New EMTALA Data Show Decline in Settlements
EMTALA’s status as an unfunded mandate and efforts to repeal the Affordable Care Act threaten the financial viability of safety-net hospitals, researchers warn, which could lead to more EMTALA violations.