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June 1, 2012

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  • If Patient Videotapes ED Care, It Could Be Used as Evidence

    While unauthorized videotapes made by a patient in your ED may seem highly inappropriate, those recordings can often be introduced as evidence in medical malpractice lawsuits, according to William Sullivan, DO, JD, FACEP, an emergency physician at University of Illinois Medical Center in Chicago and a practicing attorney in Frankfort, IL.
  • Is Your State "One-party" or "All-party?"

    In some states, only one party to a conversation has to consent for a recording to be legal, while in other states, both parties have to consent unless one of several exceptions to the law is present, such as anticipation that a crime is going to be committed or use by law enforcement, says William Sullivan, DO, JD, FACEP, an emergency physician at University of Illinois Medical Center in Chicago and a practicing attorney in Frankfort, IL.
  • Don't Disregard Any Input on ED Patient

    Some emergency physicians (EPs) have admitted that they don't take time to read the nursing notes, according to J. Tucker Montgomery, MD, JD, a health care attorney in Knoxville, TN. "Complaints recorded there that go unaddressed, or a particular abnormal vital sign, can come back to bite an EP," he says.
  • Nursing Notes May Be Hard to Find With EMRs

    "This is a new electronic record, and it does not work very well." If an emergency physician (EP) didn't review the nursing notes because these couldn't be located within the ED's electronic medical record (EMR), this statement could very well be the EP's only defense in the event a medical malpractice suit occurs, says Michael Blaivas, MD, FACEP, FAIUM, professor of emergency medicine at Northside Hospital Forsyth in Atlanta, GA.
  • Unmonitored Vital Signs "Disasters Waiting to Happen"

    Many medical conditions aren't possible to diagnose without appropriate cardiorespiratory monitoring, vital sign reassessments, and diagnostic testing, and these are "disasters waiting to happen," warns Andrew Garlisi, MD, MPH, MBA, VAQSF, medical director for Geauga County Emergency Medical Services (EMS) and co-director of University Hospitals Geauga Medical Center's chest pain center in Chardon, OH.
  • No System to Respond to Acuity, Volume Surges?

    Lawsuits related to treatment delays in EDs aren't limited to patients in the lobby who are waiting to be seen, says Andrew Garlisi, MD, MPH, MBA, VAQSF, medical director for Geauga County EMS in Chardon, OH.
  • Boarded Patients May Be "Out of Sight, Out of Mind"

    Admitted ED patients are "definitely in a gray zone," according to William C. Gerard, MD, MMM, FACEP, chairman and professional director of emergency services at Palmetto Health Richland in Columbia, SC. "Fortunately, they are admitted, and that takes your [Emergency Medical Treatment and Labor Act] risk away. But then you get into the malpractice risks," he says.
  • Lessen "Boarder" Risks With These Three Practices

    When an ED patient is being held while waiting for an inpatient bed, Rolf Lowe, JD, an attorney with Rogers Mantese & Associates in Royal Oak, MI, says "there is no bright line cut off for liability. Substandard care in the ED that has an effect on the patient's outcome can result in liability for the EP and the ED staff."
  • Should You Hold Off on Orders for ED Boarders?

    EPs may try to put off intervening on admitted patients waiting for inpatient beds to become available to avoid confusion about what was already done for the patient and what the inpatient care plan is, says William C. Gerard, MD, MMM, FACEP, chairman and professional director of emergency services at Palmetto Health Richland in Columbia, SC.
  • Screening Out of ED? There Are Legal Risks

    Is your ED considering screening out non-critical patients by giving medical screening examinations (MSEs), as required by the Emergency Medical Treatment and Labor Act (EMTALA), then giving patients a choice of seeing a primary care doctor or paying a fee?