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Case 6: Outcome

The patient arrived to the receiving hospital with oxygen saturations of 40%. The anesthesia team met the patient at the helipad, and an intubation was promptly performed. During her ICU stay she did not display any signs of neurologic recovery. After a care conference regarding her poor prognosis, her family elected to withdraw care, and […]

Case 6: Respiratory Arrest

This month’s case is about a 52 year old woman who presented to an ED with shortness of breath. She was seen by a triage nurse and immediately found to be critically ill. The patient presented with severe respiratory distress, and clearly needed to be intubated. She unfortunately had a respiratory arrest and was completely […]

Case 5: Medical Review

The decision to not obtain a head CT is the primary issue to consider in this case. There are numerous recommendations and guidelines that help ED physicians make appropriate imaging decisions after head trauma. The patient was anticoagulated (initially with a subtherapeutic INR and then with enoxaparin as well as a dose of warfarin), fell, […]

Case 5: Documentation Review

For this case we will review the documentation of the second doctor to see the patient. In particular, we will review the note that was written after he fell and returned to the ED. As usual, the Documentation Rubric will be used to grade the note. The Rubric is a tool to be used in […]

Case 5: Legal Outcome

This medical malpractice civil court case was filed in federal court. Generally, medical malpractice cases are handled at the state level. However, because the nurses involved were employees of the VA (and therefore, federal government), it was filed in federal court. The doctor involved was not a federal employee, he was working as a contractor. […]

Case 5: Physician Depositions

Both doctors were deposed in this case. The first doctor, who ordered the initial testing and recommended admission, was not named in the case. The part of her disposition about her decision to admit the patient regardless of the testing results, and her sign-out to the second doctor, are shown below. Selections from the second […]

Case 5: Nurse Expert Witnesses

There were 3 nurse expert witnesses involved in this case. The expert opinion for the plaintiff is listed first, followed by 2 expert opinions for the defendants. Expert opinion for the defense: The defense enlisted the help of a second expert witness. Which witnesses do you agree with? Continue to the next page to see […]

Case 5: Nurse Depositions

The patient’s family filed a lawsuit against the nurses involved in the case as well as the Emergency Medicine doctor who discharged him. The nurses worked for the VA, therefore the case was filed in federal court as opposed to state court. The EM doctor contracted with the VA through a locums company, so he […]

Case 5: Outcome

The patient was dropped off at home by his friend. At some point, the patient got into his bathtub. He was tragically found dead the next morning. An autopsy was completed and is shown below for email subscribers. After the patient’s death, additional information came out about the nurses involved in his ED care. Continue […]