Category: Med-Legal
Keywords: adverse event, vital signs, tachycardia, hypotension (PubMed Search)
Posted: 9/6/2024 by Robert Flint, MD
(Emailed: 9/7/2024)
(Updated: 9/7/2024)
Click here to contact Robert Flint, MD
This review reminds us that discharging emergency department patients with abnormal vital signs is a risk for the patient and the provider. The more abnormal vital signs that are present, the higher the risk of adverse event and subsequent return to the emergency department.
“Hypotension at discharge was associated with the highest odds of adverse events after discharge. Tachycardia was also a key predictor of adverse events after discharge and may be easily missed by ED clinicians.”
Always address abnormal vital signs in your medical decision making portion of the chart and be very wary of discharging anyone with tachycardia or other abnormal vital signs.
Can I Discharge This Adult Patient with Abnormal Vital Signs From the Emergency Department?
Long, Brit et al. Journal of Emergency Medicine, Volume 0, Issue 0 Articles in Press May 18, 2024 DOI: 10.1016/j.jemermed.2024.05.009
Category: Med-Legal
Keywords: chest pain (PubMed Search)
Posted: 10/4/2010 by Rob Rogers, MD
(Updated: 10/15/2024)
Click here to contact Rob Rogers, MD
Chest pain is a very high risk chief complaint in emergency medicine. And although we are told by the experts what we should write on the chart, we often struggle with finding time to do so.
Given that we can't pick up every MI, dissection, and PE, what things can we document in the chart that prove we are thorough and that we have thought about a diagnosis? And how can we document a "protective thought process" without taking too much time to do so?
Consider documenting these on your chest pain charts:
Documenting key pertinent negative comments in the chart shows that you are thinking (and considering MI, Aortic Dissection, and PE), and whenever this can be shown in a chart, there is more ammunition for the defense attorney.
Category: Med-Legal
Keywords: legal, malpractice, discovery, privacy, online (PubMed Search)
Posted: 9/12/2009 by Dan Lemkin, MS, MD
(Emailed: 9/19/2009)
(Updated: 9/19/2009)
Click here to contact Dan Lemkin, MS, MD
Beware of your online contributions, they can come back to hurt you in legal settings. You must remember that there is a digital trail of everything you post online. Discovery rules vary state to state. It is best to practice save surfing. What you may perceive as paranoia is really just good practice.
The following guidelines apply to:
General guidelines
Assume that whenever you hit send, your message will be available to a plaintiff attorney who will twist it to suit his/her needs. The only potential exception is direct email communication to your personal legal counsel. Please verify that local laws protect this form of communication before making an assumption of privacy.
[This pearl is a review of published general recommendations on privacy practices and should not be interpreted as, or replace competent legal advice.]
Brenner, Ilene MD. Anything you tweet can, and will, be used against you. Emergency Physician's Monthly. September 2009. Vol 16-9.
Category: Med-Legal
Keywords: Documentation, Chest Pain (PubMed Search)
Posted: 3/23/2009 by Rob Rogers, MD
(Updated: 10/15/2024)
Click here to contact Rob Rogers, MD
Documentation of the Chest Pain Patient
Chest pain is a high risk entity in emergency medicine. And since many patients we see with chest pain are eventually discharged, we should consider what our charts should look like should we discharge a patient who has a missed life-threatening diagnosis. In other words, what would an attorney look for?
Considerations for the chart:
Category: Med-Legal
Keywords: Chest Pain (PubMed Search)
Posted: 12/15/2008 by Rob Rogers, MD
(Updated: 10/15/2024)
Click here to contact Rob Rogers, MD
There is clearly no way you can document everything on a chest pain chart. However, there are some pretty important things that should be on the chart.
Some key things to consider documenting:
1. Daniel Sullivan, M.D.
2. The great Amal Mattu, M.D.
3. Larry Weiss, M.D.
Category: Med-Legal
Keywords: Malpractice, Sued, Deposition (PubMed Search)
Posted: 1/19/2008 by Michael Bond, MD
(Updated: 10/15/2024)
Click here to contact Michael Bond, MD
So you are getting sued. Here are some tips to handle your Deposition:
Courtesy of Larry Weiss, MD, JD
Disclaimer: This information does not constitute legal advice, is general in nature, and because individual circumstances differ it should not be interpreted as legal advice.The speaker provides this information only for Continuing Medical Education purposes.
Category: Med-Legal
Keywords: Academics, Billing, Teaching, Residents (PubMed Search)
Posted: 12/30/2007 by Michael Bond, MD
(Updated: 10/15/2024)
Click here to contact Michael Bond, MD
Fraud (PATH audits) (PATH = physicians at teaching hospitals)
So for the residents, a lot of attendings will want to be present when you do a procedure, not because they think you will need their assistance, but because, procedures are a large revenue stream that can be lost if the attending is not present.
Thanks to Larry Weiss, MD, JD
Disclaimer: This information does not constitute legal advice, is general in nature, and because individual circumstances differ it should not be interpreted as legal advice.The speaker provides this information only for Continuing Medical Education purposes.
Category: Med-Legal
Posted: 12/1/2007 by Michael Bond, MD
(Emailed: 12/8/2007)
(Updated: 10/15/2024)
Click here to contact Michael Bond, MD
EMTALA (Part Two)
Thanks to Larry Weiss, MD, JD
Disclaimer: This information does not constitute legal advice, is general in nature, and because individual circumstances differ it should not be interpreted as legal advice.The speaker provides this information only for Continuing Medical Education purposes.
Category: Med-Legal
Keywords: EMTALA, medicolegal (PubMed Search)
Posted: 12/1/2007 by Michael Bond, MD
(Updated: 10/15/2024)
Click here to contact Michael Bond, MD
EMTALA (Part One):
Thanks to Larry Weiss, MD, JD
Disclaimer: This information does not constitute legal advice, is general in nature, and because individual circumstances differ it should not be interpreted as legal advice.The speaker provides this information only for Continuing Medical Education purposes.
Category: Med-Legal
Keywords: abdominal pain, exam, legal, pitfall, missed (PubMed Search)
Posted: 11/23/2007 by Dan Lemkin, MS, MD
(Emailed: 11/26/2007)
(Updated: 10/15/2024)
Click here to contact Dan Lemkin, MS, MD
Abdominal pain can be very confusing. Occasionally, serious etiologies may masquarade as benign complaints. Always consider the following pitfalls when addressing abdominal complaints.
Disclaimer: This information does not constitute legal advice, is general in nature, and because individual circumstances differ it should not be interpreted as legal advice. The speaker provides this information only for Continuing Medical Education purposes.
Content abstracted from: Nguyen Anh, Nguyen Dung. Learning from Medical Errors. Radcliffe Publishing, UK. 2005. P 11-13.
Category: Med-Legal
Keywords: Malpractice, Insurance (PubMed Search)
Posted: 11/11/2007 by Michael Bond, MD
(Updated: 10/15/2024)
Click here to contact Michael Bond, MD
Malpractice insurance may not cover the following activities:
Disclaimer: This information does not constitute legal advice, is general in nature, and because individual circumstances differ it should not be interpreted as legal advice. The speaker provides this information only for Continuing Medical Education purposes.
Thanks to Larry Weiss, MD, JD
Category: Med-Legal
Keywords: Legal, Acute Coronary Syndrome, (PubMed Search)
Posted: 8/26/2007 by Michael Bond, MD
(Updated: 10/15/2024)
Click here to contact Michael Bond, MD
Category: Med-Legal
Keywords: Documentation, Charting, Legal (PubMed Search)
Posted: 8/11/2007 by Michael Bond, MD
(Updated: 10/15/2024)
Click here to contact Michael Bond, MD
Category: Med-Legal
Keywords: Documentation, Legal, Chart (PubMed Search)
Posted: 8/4/2007 by Michael Bond, MD
(Updated: 10/15/2024)
Click here to contact Michael Bond, MD