ED Legal Letter – June 1, 2021
June 1, 2021
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Closed Claim Malpractice Data Reveal Actual Legal Risks for ED Providers
Researchers analyzed 6,779 closed claims for adults in the ED and urgent care center settings logged between 2001 and 2015. The top five diagnoses in ED claims were: cardiac or cardiorespiratory arrest, acute myocardial infarction, aortic aneurysm, pulmonary embolism, and appendicitis.
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Aortic Aneurysm Claims Generate Highest Average Indemnity for ED
ED malpractice claims involving aortic aneurysm generated higher average indemnity ($369,872) than any other medical condition, according to a recent analysis. Failure to timely diagnose is the most common allegation in malpractice actions, followed closely by poor communication between providers.
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Most ED Malpractice Lawsuits Are Dropped, Withdrawn, or Dismissed
When an emergency physician is sued for malpractice, many immediately envision testifying in court before a jury. In reality, few ED claims (7.6%) make it that far. Most cases (65%) actually end up dropped, dismissed, or withdrawn, according to a recent analysis.
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Expert Panel Is Low-Cost Way to Determine Strength of Med/Mal Claim
If the panel finds the emergency physician deviated from the standard of care, a malpractice lawsuit is likely. On the other hand, if the panel finds the ED care was reasonable, there is a fair chance the claimant will not file suit.
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Checkbox Charting Is Problem for ED Malpractice Defense
Make sure the ED uses modified templates to allow clinicians to add free-form text. Carefully review the record for accuracy before signing the note (including automatically populated checkboxes), either contemporaneously or close in time to the encounter. Finally, maintain a strong compliance program with regular medical record audits, including a review of electronic health record systems.
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Most Sickle Cell Disease Patients Avoid EDs During Pain Attacks
In many EDs, sickle cell pain episodes continue to be managed poorly. Sixty percent of patients with sickle cell disease say they “very much” or “quite a bit” avoid going to the ED during a pain attack because of a previous bad experience. Many reported experiencing stigma because of providers’ suspicions of drug-seeking behavior. Half said they waited at least two hours for treatment.
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Medication History Often Inaccurate on Inpatient Side
Medication histories were more accurate when obtained by pharmacy technicians, according to a recent study. Of 183 patients admitted through the ED in 2017 and 2018, medication histories were accurate just 38% of the time with the usual process (typically, a nurse reviews the medication list and updates it accordingly) and 70% of the time with pharmacy technicians.
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Hospitals Could Face Legal Exposure if EPs Are Not Board-Certified
In 2005, there were about 22,000 emergency medicine board-certified emergency physicians in the United States. However, investigators estimated 40,030 emergency physicians would be needed to staff all 4,828 EDs. For years, there was not much additional research in this area. Recently, a group of investigators decided to conduct another analysis and update the data.
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Problems When Calling Patient a ‘Drug Seeker’
Is this drug-seeking label truly needed to complete the chart? What message are you trying to convey, and to whom? Who is going to read that chart once you close it, and why?