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Professional Education
Loss Lessons: Recognition of Wernicke Encephalopathy
Wernicke encephalopathy (WE) is a syndrome commonly seen in patients with alcohol use disorder who do not take adequate thiamine. WE should be suspected in any patient with conditions that may lead to malnutrition in combination with any of the following symptoms: altered mental status ophthalmoplegia, ataxia, delirium, and hypotension. Considered a medical emergency, it must be reversed to prevent permanent deficits. This case illustrates a cascade of errors which led to permanent disability. Some practical interventions to quickly recognize and reverse the condition are offered following the case presentation, which will be helpful for gastroenterology/gastroenterologists, ophthalmology/ophthalmologists, and neurology/neurologists.

Professional Education
Preventing Errors in Preoperative Clearance (Claims Corner)
Primary care providers (PCPs) routinely manage complex elderly patients with multiple comorbidities who require elective surgery. Errors can occur when providers are rushed, there is a lack of effective interoffice communication, and the patient has a low health literacy. Communication and care coordination issues are commonly noted among PCPs and consulting specialists. The Doctors Company has analyzed closed claims where PCPs have been held responsible for failures in surgical mismanagement, specifically preop clearance. This program will highlight the contributing factors identified in malpractice claims involving medical clearance and provide practice strategies for reducing liability risk.

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