Jul 01, 2023
With Law Enforcement, Be Courteous but Follow HIPAA Rules
With violent crime on the rise, especially in inner-city metropolitan areas, hospital EDs are experiencing more interactions with law enforcement personnel, says Richard F. Cahill, JD, vice president and associate general counsel with The Doctors Company.
May 17, 2023
Did Emergency Department Provider Fatigue Contribute to This Patient’s Death?
Practitioner fatigue and the rush to get things done when staffing levels are inadequate can lead to mistakes and poor patient outcomes.
Feb 10, 2023
Communication Breakdowns Lead to Missed Spinal Epidural Abscess: Case Study
Experts discuss a case involving multiple communication breakdowns that contributed to the patient’s poor outcome and provide strategies to improve processes.
Feb 03, 2023
Pediatrics: Lessons in Preventing Button Battery Injuries
It is critical for clinicians to minimize misdiagnosis and delays in care and treatment of pediatric button battery ingestions, exposures, and insertions.
Jan 05, 2023
Five Key Concerns of Medical Professionals Post-Roe
In the wake of the Supreme Court ruling in Dobbs v. Jackson, which overturned Roe v. Wade, state restrictions are colliding with clinical judgment in ways unfamiliar to many medical professionals. Physicians and other healthcare providers are facing confusion and concern about how recent legal shifts affect them and their patients.
Dec 13, 2022
Increased Risks of Delayed Care Post-Roe: Clinician Perspectives
In the wake of the Dobbs decision, which overturned Roe v. Wade, rapid changes in hospital protocols have at times amplified confusion over what is legally allowed when responding to ectopic pregnancy, miscarriage, or other obstetric complications. Clinicians in some states may feel pinned between their obligation to care for the patient and their obligation not to break the law.
Apr 01, 2022
Analysis of Cerebrovascular Accidents and Malpractice Claims
Because cerebrovascular accidents can happen at any time and in any location, it is imperative that all members of the healthcare team are able to recognize and respond to symptoms in a timely manner.
Nov 29, 2021
The Evolving Landscape of Diagnostic Errors—Challenges and Opportunities
Internationally recognized healthcare leader David E. Newman-Toker, MD, PhD, presents a compelling case example and shares key insights into transforming diagnostic accuracy.
The Doctor’s Advocate
Nov 15, 2021
To Measure and Reduce Diagnostic Error, Start With the Data You Have
Chief Medical Officer David L. Feldman, MD, MBA, FACS, recaps important recommendations by diagnostic safety expert Hardeep Singh, MD, MPH, for measuring and reducing diagnostic error.
The Doctor’s Advocate
Clinical Presentations Cause Delays: Failure to Diagnose Myocardial Infarction
In reviewing closed malpractice claims, The Doctors Company identified missed or delayed diagnosis of myocardial infarction (MI) in the ambulatory internal medicine setting as a reoccurring problem. This course highlights the importance of recognizing the varying clinical
presentations of MI and contributing factors associated with failure to diagnose and treat. Assumptions, lack of a thorough history and physical, communication failures, and failure to recognizing atypical signs and symptoms are highlighted in this case study.
Delayed Diagnosis of Stroke
In reviewing closed malpractice claims, The Doctors Company identified diagnostic failure as a reoccurring problem and one of the top three leading allegations that result in malpractice claims. This failure often leads to a delay in treatment and causes significant harm to patients. The following highlights the importance of recognizing the signs and symptoms of a stroke.
Video Oct 28, 2021
What Clinical Support Tools Can Help Emergency Department Physicians Reduce Diagnostic Errors?
Emergency department systems and processes can increase or reduce the risk of diagnostic error. But instead of simply asking clinicians to work harder or smarter, what’s needed is the creation of a system of care that optimizes their ability to think and carry out an efficient work-up of a patient. Learn more from Jacqueline Ross, PhD, RN, CPAN, our coding director.
The Need for Close Monitoring in Hyponatremia: Osmotic Demyelination Syndrome
In reviewing closed malpractice claims, The Doctors Company identified mismanagement of sodium levels during correction of severe hyponatremia as a serious problem that can result in catastrophic permanent neurological injury due to osmotic demyelination syndrome (also known as central pontine myelinolysis). This article highlights the importance of close monitoring of sodium levels during correction of severe hyponatremia, with a slow and controlled pace of sodium correction. Contributing factors discussed include clinical judgment with regard to rate of rise of sodium levels, patient monitoring, choice of practice setting, and communication between providers, especially at points of transition in care.
Jun 18, 2021
Study of Emergency Department Diagnosis Case Type Malpractice Claims: Abstract
A study of diagnosis-type closed medical malpractice claims from care that occurred in the ED from 2014 through the second quarter of 2019 using closed coded claims from The Doctors Company.
Dictation Errors in the Emergency Department
The Doctors Company identified dictation errors as a significant patient
safety risk factor. The following case highlights the importance of timely
recognition of dictation errors to ensure accuracy of the permanent
electronic health record (EHR). This is particularly important when using
a voice recognition program to document encounters in the busy
emergency department. In this case, the voice recognition system was
Dragon Direct Voice Recognition Program.
Mar 29, 2021
Is Your Patient a Victim of Human Trafficking?
Although trafficking victims rarely find opportunities to interact with others, a visit to a physician or dental practice may provide an opportunity for a victim to receive help. Learn to recognize the signs of human trafficking and know what steps to take.
Jan 28, 2021
Missed Diagnosis of Spinal Epidural Abscess
Spinal epidural abscess requires prompt diagnosis and treatment to prevent serious neurological complications.
Dec 02, 2020
The Role of Pretest Probability in the Evaluation of Suspected Venous Thromboembolism
The presenting signs and symptoms of venous thromboembolism are often vague and nonspecific, and early diagnosis—often crucial to the patient’s outcome—may be challenging.
The Doctor’s Advocate
Spotlight on Diagnosing PE/DVT
The overall incidence of venous thromboembolism (VTE) —including both deep vein thrombosis (DVT) and pulmonary embolism (PE) —is one case per 1000 patient years. Accurate and timely diagnosis of VTE can be improved with the use of diagnostic guidelines such as Wells criteria and scoring for both DVT and PE.
Cauda Equina Syndrome: A Failure to Diagnose
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when patient assessments are incomplete, having a narrow diagnostic focus, or diagnostic test issues. Other factors that hinder timely diagnoses include failure to appreciate signs and symptoms, lack of consults, and failure to respond to repeated patient concerns/symptoms.
Aug 25, 2020
Distracting Devices in Healthcare: Malpractice Implications
Digital distraction in healthcare is a threat to patient safety and physician well-being. Personal electronic devices can create a digital distraction so engaging that it consumes awareness, potentially preventing healthcare providers from focusing on the primary task at hand—caring for and interacting with patients.
Aug 27, 2019
Electronic Health Records Continue to Lead to Medical Malpractice Suits
We analyzed 216 medical malpractice claims that closed from 2010 to 2018 in which EHRs contributed to patient injury. The pace of these claims grew, from a low of seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018. As EHRs approach near-universal adoption, they may become a more prevalent source of patient safety risk.
Mar 20, 2019
Study of Malpractice Claims Involving Children
The Doctors Company analyzed 1,215 claims filed on behalf of pediatric patients that closed from 2008 through 2017. The study is based on the claims filed against physicians in 52 specialties and subspecialties and includes an overview of the most common types of claims, expert insights into the specific elements that led to patient injury, and risk mitigation strategies.
Dec 26, 2018
Mitigating the Risk of Osmotic Demyelination Syndrome
Insights into managing patients with severe hyponatremia.
The Doctor’s Advocate
Video Sep 04, 2018
What to Expect from Litigation: Dr. Gupta's Perspective
Adverse outcomes sometimes occur even when physicians follow the standard of care and do all they can for their patients. This video, the third in a series showcasing actual claims experiences, highlights the stress and worry that accompany a medical malpractice lawsuit. Emergency medicine physician Dr. Malkeet Gupta recounts how being sued for medical malpractice affected him.
Video Sep 12, 2017
Emergency Medicine: Innovations in Patient Safety
Roneet Lev, MD, FACEP, chief of the emergency medicine department at Scripps Mercy in San Diego, California, describes changes her department made to improve patient safety based on the data and recommendations in The Doctors Company’s Emergency Medicine Closed Claims Study. The study identified the need for rapid recognition of stroke patients and treatment for tissue plasminogen activator (tPA).