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"Many times, something as simple as a check mark as to whether the patient had anything to eat or drink while they were in the ED may become an important fact in the defense of a lawsuit," says Stimmel. Here are some of Stimmel's recommendations:
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Though myocardial infarction is often a key area of focus when it comes to ED misdiagnoses and subsequent lawsuits, appendicitis is another common and serious misdiagnosis in the ED.
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Last month's ED Legal Letter analyzed some recent tort reform court battles. This month, we review cases where physicians are suing state governments to stop them from pilfering the cash in patient malpractice compensation funds, and a few more cases litigating state and federal tort laws.
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"This takes the longest to document," he says. "I might not remember every piece of history I asked, or every part of the physical exam that I did, even with computer guidance," he says. "But I spend most of my time on medical reasoning."
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There are many things that factor into missing a diagnosis of appendicitis, says William Sullivan, DO, JD, FACEP, director of emergency services at St. Mary's Hospital in Streator, IL.
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Aggressive approach to CVD reduces MI, folic acid and vitamin B12 for CAD, corticosteroids for acute exacerbations of COPD, prescription drug abuse among young adults, and ARBs and cancer risk.
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A 51-year-old man was brought to the emergency department with severe abdominal pain and hypotension. He had no known chronic medical disease but for the past few months had experienced a loss of appetite, weakness, and fatigue. Despite these symptoms, he had not missed work (electrical engineer). Over the six months, his weight had fallen from 190 to 175 pounds. He did not recall night sweats or fever, but did mention that he experienced a loss of appetite and occasional nausea. On two occasions during the prior week, he vomited.
