Trying to order medications for a heart attack victim using electronic medical records, White Coat is frustrated to run into screen after screen preventing him from completing the order without addressing unlikely allergy issues (and thus protecting the hospital from liability):
For those of you who don’t know what alarm fatigue is, think of a car alarm. The first time you hear it going off, you run to your window to see who’s breaking into a car. Maybe you run to the window the second time and the third time, too. By the tenth time the alarm goes off, you’re thinking that the alarm is broken and someone needs to get that fixed. After about thirty false alarms, you’re feeling like going out there and busting up the car yourself – especially if the car alarm wakes you when you’re asleep.
It’s a concept with many applications beyond the emergency room setting, too, product warnings being just the start.
P.S. Dr. Westby Fisher has some related thoughts about the limits of trying to engineer physician responsibility through electronic records design.
On July 12 New York Times columnist Jim Dwyer wrote an extensive story about the death of a 12-year-old boy who had been brought to an emergency room with fever and rapid pulse, sent home, and died of septic shock. Lab test results and other indicators of distress allegedly went unheeded, and the boy’s family is represented by Thomas Moore, perhaps the city’s premier medical malpractice lawyer. Some legal blogs had a field day citing Dwyer’s article as an example of flagrant medical malpractice, as they depicted it; other reactions, some gathered in a Dwyer follow-up column, were more mixed.
White Coat, the blog at Emergency Physicians Monthly, has been resistant to the Dwyer-Moore narrative of the case. Its blog posts can be found here,
here, here, and here.
- How’d we get shortages of hospital and community sterile injectables? Check out the role of FDA Good Manufacturing Practice (GMP) regs, warning letters, and resulting plant closures [Tabarrok, with comments controversy; earlier here, here, here, etc.]
- California orthopedist sues, wins damages against medical society that took action against him based on his testimony for plaintiff in liability case [American Medical News; earlier here, etc.]
- Can’t have that: medical apology should be opposed because it “can create an emotional connection with an injured patient that makes the patient less likely to ask for compensation.” [Gabriel Teninbaum (Suffolk Law), Boston Globe]
- Feds’ war on painkillers is bad news for legit patients and docs [Reuters, Mike Riggs/Reason]
- New federal pilot project in Buffalo will provide concierge-style home care to emergency-department frequent fliers. Spot the unintended consequence [White Coat]
- Dastardly drug companies? Deconstructing Glaxo SmithKline’s $3 billion settlement [Greg Conko, MPT] More: Beck, Drug and Device Law, on suits over “what are mostly medically valid and beneficial off-label uses”. Paging Ted Frank: “HIPAA’s Vioxx toll” thesis may depend on whether one accepts that the premised Vioxx toll has been established [Stewart Baker, Ted's recent post]
- U.K.: “Lawyers seizing lion’s share of payouts in NHS negligence cases” [Telegraph]
- Silver linings in SCOTUS ObamaCare ruling? [Jonathan Adler and Nathaniel Stewart] “DNC Scientists Disprove Existence of Roberts’ Taxon” [Iowahawk humor] Did Ginsburg hint at the court’s direction on the HHS contraception mandate? [Ed Morrissey, Hot Air]
[cross-posted at Cato at Liberty]
That’s what Connecticut plaintiff’s lawyer Craig Yankwitt said on filing a lawsuit against Stamford Hospital’s Tully immediate-care unit for allegedly missing pulmonary embolisms in a Greenwich man who came in complaining of flank pain. [Connecticut Post] White Coat analyzes what it would mean for emergency departments to hold on to patients until any possible life-threatening conditions had been ruled out.
It actually turned out to lengthen patient stay times in UK emergency rooms, which did not surprise White Coat.
White Coat examines the case of King v. St. Barnabas, in which a New York appellate court approved a suit against first responders who failed in attempts to revive a prison guard who collapsed while playing basketball and was found unresponsive and not breathing. [Emergency Physicians Monthly] A different view: Max Kennerly.
Alabama: “A Jefferson County jury has awarded $2.4 million from an emergency physicians group to the mother of a 2-year-old who died after ingesting methadone.” Lawyers said the emergency department failed to take proper steps to rule out drug overdose as a reason for the child’s condition. [AP/WHNT via White Coat]
Plus: A more explanatory news account (h/t commenter John Rohan).
A bill in the California legislature held out hope for encouraging wider adoption of the lifesaving devices, but couldn’t make it past the Litigation Lobby. [John Frith, California Civil Justice Blog]
“Plenty, if you ask the people most familiar with the situation, the emergency physicians themselves.” [KevinMD, Emergency Physicians Monthly, White Coat, WSJ Law Blog] Relatedly: “Just to be sure: an ER slippery slope” [MedRants, WhiteCoat] And yesterday, from the AP.
White Coat’s trial is in fact concluded, so he’s not liveblogging it, but recounting it after the fact; posting while the trial was in progress was what got Boston pediatrician “Flea” into so much trouble a couple of years ago after the posts came to the attention of opposing lawyers. [first, second posts] Some reactions: Eric Turkewitz, MedicineThink.
Today’s WSJ covers the story, which has been around for a while, and Dr. Wes has one reaction. We’ve had numerous posts touching on the liability implications of keeping defibrillators on hand at public places, not keeping them on hand, or both.