Malpractice in Emergency Medicine—A Review of Risk and Mitigation Practices for the Emergency Medicine Provider

Ferguson, Brian; Geralds, Justin T.; Petrey, Jessica; Huecker, Martin

doi:10.1016/j.jemermed.2018.06.035

Cited by 38 publications

(24 citation statements)

References 46 publications

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“…It has been described that abdominal pain is amongst the most frequent problems associated with malpractice claims at the emergency department [15]. Other issues are the occurrence of unexpected diagnoses [16] of extra-abdominal origin [17] and problematic "off-hour" presentations with abdominal pain.…”

Section: Introductionmentioning

confidence: 99%

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Osterwalder

Özkan

Malinovska

et al. 2020

JCM

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Abdominal pain (AP) is a common reason for presentation to an emergency department (ED). With this prospective, observational all-comer study, we aimed to answer three questions: Which diagnoses are most often missed? What is the incidence of extra-abdominal causes? What is the prognosis of abdominal pain in a tertiary urban European ED? Participants were systematically interviewed for the presence of 35 predefined symptoms. For all patients with abdominal pain, the index visit diagnoses were recorded. Related representation was defined as any representation, investigation, or surgery related to the index visit (open time frame). If a diagnosis changed between index visit and representation, it was classified as missed diagnosis. Among 3960 screened presentations, 480 (12.1%) were due to AP. Among 63 (13.1%) related representations, the most prevalent causes were cholelithiasis, gastroenteritis, and urinary retention. A missed diagnosis was attributed to 27 (5.6%) presentations. Extra-abdominal causes were identified in 162 (43%) presentations. Thirty-day mortality was comparable to that of all other ED patients (2.2% vs. 2.1%). Patients with abdominal pain had a low risk of representation, and the majority of representations due to missed diagnoses were of benign origin. The high incidence of extra-abdominal causes is noteworthy, as this may induce change to differential diagnosis of abdominal pain.

show abstract

Section: Introductionmentioning

confidence: 99%

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Osterwalder

Özkan

Malinovska

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…However, perceived or genuine conflicts of interest may be inevitable in recruiting persons with the expertise required for the GRACE panels. Finally, to reduce practice variability and malpractice risk and improve patient safety, multiple opinion leaders identify the creation of pertinent, updated, and feasible guidelines as an essential resource 23,24 . Despite these recommendations, some argue against organizations like ACEP and SAEM creating clinical practice guidelines, particularly when high‐quality, indisputable evidence is lacking 25,26 .…”

Section: Figurementioning

confidence: 99%

Navigating uncertainty with GRACE: Society for Academic Emergency Medicine’s guidelines for reasonable and appropriate care in the emergency department

Carpenter

Bellolio

Upadhye

et al. 2021

Academic Emergency Medicine

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“… 30 Although AIS is not considered high risk for litigation occurrence compared to other emergency department diagnoses, mitigation steps such as constructive communication and intelligent documentation are paramount. 31 Ultimately, stakeholders in acute stroke care should align such that more multi-faceted views can be represented in national guidelines.…”

Section: Understanding Malpractice Risk and Conclusionmentioning

confidence: 99%

Alteplase for Acute Ischemic Stroke Beyond 3 hours: Enthusiasm Outpaces Evidence

Garg

2021

WJEM

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Malpractice in Emergency Medicine—A Review of Risk and Mitigation Practices for the Emergency Medicine Provider

Cited by 38 publications

References 46 publications

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Acute Abdominal Pain: Missed Diagnoses, Extra-Abdominal Conditions, and Outcomes

Navigating uncertainty with GRACE: Society for Academic Emergency Medicine’s guidelines for reasonable and appropriate care in the emergency department

Alteplase for Acute Ischemic Stroke Beyond 3 hours: Enthusiasm Outpaces Evidence

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