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Emergency Room Errors

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Emergency Rooms, or ER's, at hospitals all over the country are the most stressful worksites in the healthcare profession. The standard of care in United States hospitals is high quality. Doctors, nurses, surgeons, and all other healthcare professionals take pride in this. However, the fact remains that malpractice occurs in the medical profession and today's hospitals need to improve the care provided in their Emergency Departments.


Errors in hospital Emergency Rooms are a common occurrence infrequently talked about and rarely reported to the media. That is why you don't hear about these types of cases on the news. Understaffed hospitals, ill-equipped emergency rooms, and poorly trained staff may lead to fatal errors when dealing with patients requiring emergency treatment. Let’s face it – when you arrive at your local hospital ER you know absolutely nothing about who will be taking care of you and there is no time to research the competency and track record of the ER staff. 


There are many ways that errors or malpractice may occur in Emergency Rooms. The following is a partial list of some of the Emergency Room medical negligence cases we have handled:


·        Medication Errors

·        Prescription Errors

·        Failing to diagnose impending heart attacks and strokes

·        Diagnosis Errors

·        Errors in interpreting x-rays, CT scans, and MRI studies

·        Discharging patients who are critically ill


Over 225,000 people die from medical malpractice related injuries in a single year and nearly half of these deaths are from emergency room errors.


The following a partial list of the more common medical errors which arise in the Emergency Department: 


Failing to administer prophylactic antibiotics in patients with open fractures.  An open fracture is one in which the bone has broken through the skin, and as such, these fractures present an increased likelihood of infection.  The best outcome for these patients is dependent upon prevention of infection and obtaining a quick union of the fracture.  Prophylactic antibiotics reduce the risk of infection and should be given as soon as possible. 


Failing to diagnose compartment syndrome in patients with tibial fractures.  The tibia is the larger of the two bones of the lower leg and is the weight-bearing bone of the shin.  A compartment syndrome is a serious complication which occurs when the pressure in a closed fascial compartment rises sufficiently high to cause nerve and tissue injuries. Without timely diagnosis and treatment, compartment syndrome can cause permanent loss of use or function in the involved extremity (legs or arms).  The clinical signs of compartment syndrome include pain out of proportion to the injury, pain on passive range of motion, and loss of distal pulses.  Immediate consultation with a surgeon is the preferred course of treatment.


Failing to treat a perirectal abscess in a diabetic patient as an emergency.  Patients who are diabetic present many unique challenges to their health care providers.  A perirectal or perianal abscess is a pool of pus that forms next to the anus, often causing considerable tenderness and swelling in that area and pain on sitting down and on defecating.  These abscesses or infections have a tendency to rapidly progress to deeper, more serious infections in diabetic patients.  The abscess can develop into Fournier’s gangrene, a life-threatening infections with a reported mortality rate of 9% - 43%.  Again, prompt consultation with a surgeon is the preferred course of action.


Failing to provide the proper airway for patients with facial or skull fractures.   Establishing and securing an airway is one of the first steps addressed by all Emergency Departments.  There are several ways to accomplish this goal but the main techniques are tracheal intubation (either oral or nasal), bag and mask, or a surgical procedure known as a cricothyroidotomy.  Emergency physicians should almost never attempt a nasal tracheal intubation in patients with facial or skull fractures due to the possibility of passing the tube into the cranial vault and thereby cause even more serious injuries.


Failing to admit unstable patients or patients with unclear diagnoses to the hospital.  Remember, the Emergency Room doctor’s first responsibility is to stabilize the patient and then make appropriate decisions about the patient’s continuing care needs.  Most ER doctors do not have admitting privileges at the hospital – they must contact the patient’s regular doctor or the hospital admitting doctor for permission to admit the patient directly from the ER into the hospital.  Almost everyone has a story about a friend or family member who was discharged from the Emergency Room returned to their home and within hours or a couple of days suffered a disastrous outcome.  Make sure your friend or family member is stable, and with a plan of treatment, before discharge from the ER.

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Dan Frith is a member of the Virginia State Bar, the Virginia Trial Lawyers Association and the American Trial Lawyers Association.

Mr. Frith is a graduate of Virginia Polytechnic Institute and and State University and the Washington and (more...)
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