A man without cardiac risk factors dies of a heart attack after being sent home from the ER. It is successful malpractice cases like these that cause ER physicians to defensively admit everybody to rule out an MI, further ballooning health care costs.
As the defense states, the only definitive test to determine whether someone has heart disease is a cardiac catheterization. The day is coming when lawsuits push this test become standard of care in the ER. (via PointofLaw.com)
Related posts:
- A rare cause of chest pain
- The 30-year old patient with chest pain
- Chest pain in the ER
- The pain of a malpractice lawsuit
- Discharging ER chest pain home
- For doctors, a malpractice lawsuit is personal
- Misreporting lab results leads to malpractice
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{ 10 comments }
I already do admit everybody, including 20 year olds with chest pain. The question now is whether you Chest CT everybody with chest pain to rule out dissection and PE. The biggest problem us malpractice avoiders who are stuck doing ER face is that you cannot do a CT to Rule out PE and Dissection with one scan usually, so you can only choose one. I do the dissection CT in the ER, then admit the 20 year old for hopefully an inpatient VQ scan. What a joke.
Dude,
Convince your hospital to get a 60 slice CT scanner. Every chest painer gets a triple rule out CT for dissection, PE, and CAD. Add a li’l gastrograffin orally and you’ll be able to rule out a Boerhaave’s as well.
Sheesh, we’re already doing a full body CT scan for all trauma patients as soon as they hit the door or the ED anyway so why not for everything else?
The problem I see with the triple slice ct scanner: All the cocaine addicts I see. If I admit them i’m not responsible for them. If I do the CT scan and discharge them, they’ll go out and use cocaine, and I’ll be responsible for their arrhythmias that occur for the ten days after they leave my ER. I’ll still admit all my Chest pains. You know the lawyers will find a way around this new technology.
Who is the asshole ER doc who testified for the plaintiff?
I bet he’s loving his fat payoff from the lawyer. I bet he makes 10 times more money testifying in lawsuits than he does by practicing medicine in the ER. I hope somebody sues the hell out of him someday for some bullshit reason.
They carefully never gave the age of the man who died, I notice.
Two days ago in the ER I saw a 45 year woman who simply fainted after admitting to “hyperventilating” and becoming “emotional” while visiting with her long time friend on hospice dying of cancer.
Her EKG was normal except the QT interval was almost borderline long. She was admitted about one month prior and had the complete cardiac and pulmonary work up. I was ready to send her home and had discharge instructions written when her cardiologist happened to be in the ER. She wanted to go home but he saw her and admitted her. She is still in the hospital 2 days later after having had a V/Q scan (after a negetive d-dimer), ruled out for MI, head CT, Nuc med stress test, pulmonary and neurology consult, all for a simple fainting episode.
The insurance company probably paid me 150$ for her ER visit and I was willing to send her home, take the liability, and save the insurance company $20,000 on the worthless admission.
Just F*** it. Admit them all. Bankrupt the whole f****** system. Maybe I will take the liability if the ins. co. is willing to pay me half of that 20k admission.
What the f*ck do we gain by taking the risk? Why would you EVER send home a smoker no matter why they come to the ER? Why should I take the risk for their smoking? My admission rate has gone up every year I’ve done this crap, and it can only go higher.
To the writer who asks “who’s the asshole ER DOc who testified for the plaintiff?” Sounds like it wasn’t an ER DOc. It was a cardiologist. Usually they get a cardiologist to rape you if it’s a cardiac case (or if the plaintiff’s sodomite wants to say the “cause of death” was cardiac, it’s not always clear). When a friend of mine got sued for sending home a healthy 30 year old with normal EKG who later died, the sodomite had a cardiologist say under oath that the “standard of care” is to admit 30 year olds with chest pain for a cardiac workup. The sodomite was unsuccesfull.
It is about time the profession started to police its own. While there is little that the community can do to strip the licensure of the plaintiff’s whores that sell their souls to the ATLA, the least that one can do is toss them out of the appropriate professional organizations for unethical behavior. I can understand the desire to “protect your own” but these scumbag “doctors” are no better than the ATLA lawyers and are happy to visit ruin upon their colleagues for a few dollars.
Got news for you NoFavors :
If that patient is privately insured, the insurer almost certainly denied the admission. The hospital is left holding the bag.
Amazing. Why doesn’t submit th reactions in this post to CNN, ABC news, etc. Want to jolt the system. Get thm to read this and bring this debate to the american public. Then maybe, people will understand why they can’t afford insurnce and why hospitalization costs so much and why doctors order so many tests and why everyone in medicine is truly pissed off. All this for what, $175,000. Trust me, my cousins own 3 dunkinn donuts, 1 is an investment banker, several a pharmacists. They all make more. Who needs this headache.
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