Articles

As the first medical malpractice insurer to establish a patient safety department, we set the industry standard with innovative products and services that reduce risk in your practice and help you avoid claims. Our commitment extends to the insightful content offered here.

General Risk ARTICLES		Specialty-SPECIFIC Risk ARTICLES
Alerts Best Practices Case Studies Claims Reviews Communication FAQs Hospitals and Facilities Informed Consent Interactive Guides/Site Surveys Keys to Patient Safety Litigation and Claims Practice Guidelines Professional Conduct Record Keeping Risk Management Risk Tips		Anesthesiology Cardiology Dentistry Emergency Care General Surgery Hospitals Hospitalists Internal Medicine Neurosurgery		Obstetrics and Gynecology Oncology Oral and Maxillofacial Surgery Orthopedics Pathology Plastic Surgery Primary Care Psychiatry

Clinical Departments: Emergency Medicine Services (PDF)
Emergency medicine services can have areas of potential malpractice exposure, and this guide can help uncover risks.

TIA Recognition and Management
David B. Troxel, MD
Failure to recognize subtle transient neurologic deficits as a transient ischemic attack or a harbinger of impending stroke can lead to a claim if a stroke subsequently occurs.
From The Doctor's Advocate

Emergency Medicine
Arlene Luu, JD, RN
In emergency medicine, doctors can reduce potential liability by following risk management strategies, such as establishing clear protocols for tests and radiology follow-up.

Interactive Guide to Patient Safety for Emergency Medicine Physicians (PDF)
The practice of emergency medicine can have areas of potential malpractice exposure, and this guide can help uncover risks.

It Hurts: The Patient with Noncancer Pain
Susan Shepard, MSN, RN, and Howard Marcus, MD, FACP
Physicians who treat acute and chronic pain need to be comfortable and secure in their competency and cognizant of the correct dosing guidelines, which may have dramatically changed in the past decade.

Challenging Communications
Laura A. Dixon, JD, RN
Communication breakdowns are a frequent risk management finding in claims, as highlighted in this case study.

Did Provider Fatigue Contribute to This Patient's Death?
Mary Lerch, RN
Provider fatigue and the rush to get things done when staffing levels are inadequate can lead to mistakes and poor outcomes for patients.

Emergency Medicine Closed Claims Study (PDF)
Darrell Ranum, JD, CPHRM
A review of 581 emergency medicine claims to identify top allegations and factors contributing to patient injury.

Analysis of Cerebral Vascular Accidents and Case Studies
Mary Lerch, RN
Physicians can improve patient prognosis by educating staff to recognize signs and symptoms of cerebral vascular accidents (CVAs).

Prescription for Medication Safety
Howard Marcus, MD, FACP
This article examines the increase in accidental overdose of opioids and makes recommendations for reducing the risk of patient harm.

Who's in Charge?
David B. Troxel, MD, Medical Director
This case study illustrates the importance of promptly diagnosing and treating spinal epidural abscess.

Dilaudid-Related Morbidity and Mortality from Respiratory Depression
Howard Marcus, MD, FACP
In the case of Dilaudid, an increase in overdosing has been complicated by an apparent lack of understanding by some physicians and nurses of what represents a safe dose.

A Patient with Chest Pain of Sudden Onset
David B. Troxel, MD, Medical Director
A case study illustrates the importance of rapidly identifying acute dissections involving the ascending aorta. "Protecting Against Missed Diagnoses" is a companion to this article.
From The Doctor's Advocate

Abdominal Aortic Aneurysm: Failure to Inform Patient and Monitor Aneurysm
David B. Troxel, MD, Medical Director
This case study highlights the importance of screening for and monitoring abdominal aortic aneurysms.

Evaluate Chest Pain with Caution
John Dale Dunn, MD, JD
Problems related to diagnosis or treatment of ischemic heart disease are among the leading causes of medical malpractice claims in emergency rooms today.