Case 9: Lawsuit Outcome
The family member’s of the patient contacted a law firm after the patient’s death. A lawsuit was initially filed in state court, alleging medical negligence. When a malpractice lawsuit is filed, the initial claims by the plaintiff are termed a “complaint”. As the lawsuit progresses, the plaintiff can request permission to amend their complaint under […]
Case 9: Depositions
A lawsuit was filed over the patient’s death. The defendants named in the lawsuit included both ED physicians, their employer, the hospital where the ED is located, the surgeon, and the surgery center. The ED physician who discharged her with a heart rate of 142bpm shortly before her death was deposed. Here he is being […]
Case 9: Outcome
The patient returned home with her husband. She got up at one point to take her medication. When her husband checked on her again about 4 hours later, he tragically found her deceased in bed. An autopsy was conducted. The relevant information from the autopsy is included below. The entire autopsy is too long for […]
Case 9: Return Visit
The patient returned home after being discharged around 6pm, but the pain continued to be quite severe. She called 911 about 2 hours, and returned to the ED. The EMS report is shown below. Her vitals were 82bpm, 18 respirations/minute and BP 131/72. Her O2 saturation was 99%, but for some reason 4L O2 was […]
Case 9: Disposition
The nursing notes for the patient are shown below. The patient was given 3 doses of morphine, each 4mg. She was also given 1L of fluids through a 22 gauge IV. The patient’s vitals throughout her stay were recorded by nursing staff. Her heart rate improved from 100bpm to 89bpm. Her blood pressure was normal […]
Case 9: Abdominal Pain
A 47-year-old woman presented to the ED on November 6 with abdominal pain. The patient had undergone a Roux-en-Y gastric bypass surgery on October 20. She had developed worsening abdominal pain, and went to see a nurse practitioner at an outpatient clinic. She was given Rocephin and Phenergan, and then referred to the ED. On […]
Bouncebacks! Book Review
When I first got interested in reviewing medical malpractice cases, one of the best resources I found was the book Bouncebacks! Emergency Department Cases: ED Returns, by Michael B. Weinstock and Ryan Longstreth. As a resident I devoured the book and found many clinical pearls that made me a better doctor. Dr. Weinstock kindly provided […]
Case 8: Documentation
The initial urgent care documentation will be assessed with the Documentation Rubric. The Rubric and Template were created specifically for EM notes, but they apply equally well to any undifferentiated patient with an acute complaint. The Documentation Template was created for clinicians to use while working, in order to create defensible documentation. This is specifically […]
Case 8: Review
The medical review of this case is somewhat limited. The lawsuit did not stem from any failure of medical workup or treatment. We will focus on two distinct themes that contributed to this bad outcome, and several ways that similar mistakes can be avoided. First, the physician either did not perform a full review of […]
Case 8: Legal
The patient contacted a medical malpractice attorney, and a lawsuit was filed. The patient learned of his cancer 3 years after the original urgent care visit, and the lawsuit was filed 2 years after he was diagnosed with cancer. During the lawsuit discovery process, the plaintiff came to the realization that the physician was an […]