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The credibility of "dueling experts" testifying before a jury often determines the outcome of a lawsuit alleging malpractice by an emergency physician, but in fact, expert witnesses typically get involved weeks before a case is even filed.
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Historically, emergency department (ED) triage was rarely a high-risk issue for hospitals, primarily because short waiting times resulted in all patients being seen quickly by the emergency physicians. Today, the combination of overcrowding, markedly prolonged waiting times, increasing numbers of patients leaving the ED before examination, the nursing shortage, diminishing financial support, and federal Emergency Medical Treatment and Active Labor Act (EMTALA) mandates make triage a very dangerous encounter for the patient and a fertile source of litigation against providers.
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We should all be aware of the four components of malpractice the physician had a duty, breached the duty, there was harm to the patient, and the harm was caused by the breach of duty.
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Every trial usually comes down to a "battle of the experts," with the jury judging the credibility of the experts and making their decision. Consider these important factors, advises Linda M. Stimmel, a partner with the Dallas, TX-based law firm of Stewart Stimmel: Experience, education, training, the effectiveness of how the expert communicates with the jurors, and the bedside manner of the expert. "Even how the expert is dressed may affect their credibility."
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This is the second of a two-part series on delayed diagnoses in the ED. This month, we report on legal risks involving time-dependent medications and interventions.
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[Editor's note: Dr. Banja is a Professor in the Department of Rehabilitation Medicine; a Medical Ethicist at the Center for Ethics; and the Director of the Section on Ethics in Research at Emory University in Atlanta. E-mail:
[email protected].]
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While psychiatric advance directives are not new in concept, patients tend not to take advantage of these tools.
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A study published in the March 9, 2009, issue of Archives of Internal Medicine, which revealed that patients with advanced cancer who reported talking to their physicians about their end-of-life care wishes had significantly lower health care costs in the last week of life.
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Feelings of abandonment on the part of patients and their caregivers are not uncommon as they transition from treatment to end-of-life care, according to a recent study completed by a team at the University of Washington.
