A triage nurse’s note stating that a patient had fever and hip pain in his prosthetic hip became a key area of focus during a recent malpractice trial. At deposition and at trial, the emergency physician (EP) claimed to have examined the hip, and found that the patient did not have increased pain with range of motion.
A recent malpractice case involved a patient who was discharged from an emergency department (ED) with a diagnosis of benign positional vertigo. “She was having a stroke, and was returned to the hospital a few hours later with an occluded basilar artery,” says Gary Mims, JD, a partner at Sickels, Frei and Mims in Fairfax, VA.
Did an emergency physician (EP) come off poorly during a deposition, volunteer some damaging information, or inadvertently complicate the defense of a co-defendant? If so, “it will significantly change the perspective of the defense attorney, the hospital, or the insurance company on whether the case should settle and for how much, in a way that’s going to be adverse to the EP,” warns John Burton, MD, chair of the Department of Emergency Medicine at Carilion Clinic in Roanoke, VA.
Many emergency physicians (EPs) assume that all aspects of the peer review or quality improvement processes involving emergency department (ED) care are automatically protected from discovery during malpractice litigation. This is not necessarily the case.
Lack of documentation on patients with high-risk-conditions often results in the settlement of otherwise defensible claims against emergency physicians (EPs), according to Douglas Segan, MD, JD, FACEP, a medical-legal consultant based in Woodmere, NY.