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.
Tagged as:
allergies,
emergency medicine,
overwarning,
pharmaceuticals
- “On Average, Physicians Spend Nearly 11 Percent Of Their 40-Year Careers With An Open, Unresolved Malpractice Claim” [Health Affairs via Pauline Chen, NY Times]
- SCOTUS lets stand Feds’ “accept Medicare or lose your Social Security” edict [Ilya Shapiro, Cato]
- Robot surgery: from the Google ads, you might think lawyers are circling [Climateer via Tyler Cowen]
- New York mandates more aggressive anti-sepsis measures in hospitals, and White Coat thinks it won’t end well [EP Monthly]
- Shortages of generic FDA-regulated sterile injectables begin to take deadly toll [AP/Worcester Telegram, earlier]
- Continuing the discussion of electronic medical records from a few days back: as medico-legal documents, EMRs are under pressure to be something other than candid and spontaneous [Kaus] While other patients wait for critical care, ER docs and nurses enter mandatory data fields for whether the infant is a smoker or the flu victim is a fall risk [White Coat]
- Obamacare part-time-work fiasco “only starting to become news when it hits university professors” [Coyote, David Henderson, earlier]
Tagged as:
emergency medicine,
hospitals,
medical malpractice,
Medicare,
ObamaCare,
pharmaceuticals
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.
Tagged as:
emergency medicine,
hospitals,
medical malpractice,
New York Times,
NYC
- 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]
Tagged as:
emergency medicine,
expert witnesses,
FDA,
HIPAA,
John Roberts,
medical apology,
ObamaCare,
pharmaceuticals,
Supreme Court,
United Kingdom,
Vioxx
- Primer on “severability”: would ObamaCare fall if individual mandate struck down? [Loyola, Epstein, Shapiro, American Interest] Maybe the President picked the wrong fight: “Supreme Court’s Ratings Jump Following Health Care Hearings” [Randy Barnett]
- Heritage on med-mal reform and federalism [Hans von Spakovsky; my take] A case for New Hampshire’s “early offer” med-mal proposal [Robinette, TortsProf] “Ohio’s tort reform has curbed soaring malpractice costs” [Columbus Dispatch editorial]
- Madison County: plaintiff’s lawyer seeks gag order in med-mal case [MC Record]
- Academics debate whether authorities should crack down on medical tourism [Cohen et al, Opinio Juris]
- Shortage of physician volunteers at marathon sports events, readers of this site can guess the reason [Outside mag via White Coat]
- Connecticut Gov. Malloy proposes letting home health workers rather than nurses administer pills to homebound patients, major savings foreseen [Connecticut Mirror] Related, David Henderson;
- Governments now often cite HIPAA as reason not to release information regarding accidents, crimes and disasters [Glenn Cook, Las Vegas Review-Journal] How HIPAA implementation can keep patient history out of emergency medical responders’ hands [EP Monthly]
- London: Red Ken has pay doc, NHS being Not His Style [Marian Tupy, Cato at Liberty]
Tagged as:
Connecticut,
emergency medicine,
HIPAA,
medical malpractice insurance,
New Hampshire,
ObamaCare,
Ohio
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.
Tagged as:
Connecticut,
emergency medicine
- Ray LaHood’s forgotten predecessor: “How One Bureaucrat Almost Succeeded in Banning Car Radios” [Mike Riggs, Reason]
- “Some Recent Nonsense on Freedom of Religion in the Times” [Paul Horwitz, Prawfs]
- Choice of Ben Stein as speaker for ABA Tech Show raises eyebrows [Derek Bambauer, InfoLaw]
- “Oblivion video game ‘Abomb” becomes federal lawsuit” [Abnormal Use]
- Tort causation: “Probability for thee, mere possibility for me” [David Oliver]
- Washington state says it won’t pay for “unnecessary” Medicaid ER visits. Can you see the unintended consequences coming? [White Coat]
- Utah says family can’t fundraise for son’s legal defense without permit [Standard-Examiner via Balko]
Tagged as:
autos,
Ben Stein,
churches,
emergency medicine,
Utah,
videogames,
Washington state
- Correct result, yet potential for mischief in latest SCOTUS climate ruling [Ilya Shapiro/Cato, my earlier take]
- Wouldn’t even want to guess: how the Howard Stern show handles sexual harassment training [Hyman]
- Philadelphia: $21 million award against emergency room handling noncompliant patient [Kennerly]
- Antitrust assault on Google seems geared to protect competitors more than consumers [Josh Wright]
- “They knew there was a risk!” Curb your indignation please [Coyote]
- Theme issue of Reason magazine on failures of criminal justice system is now online;
- “Why Your New Car Doesn’t Have a Spare Tire” [Sam Kazman, WSJ]
Tagged as:
antitrust,
autos,
broadcasters,
climate change,
crime and punishment,
emergency medicine,
global warming,
Google,
harassment law,
Philadelphia,
safety
- Verbal fireworks from Judge Kozinski in Ninth Circuit “stolen valor” case [Above the Law]
- Measure of artificially contrived scarcity: “NYC Taxi Medallions Approach $1 Million.” Would officials in Washington, D.C. really consider introducing such a destructive system? [Perry, more]
- Workers’ comp OK’d in case where simulated chicken head blamed for subsequent emotional disability [Lowering the Bar]
- “NBA referee sues sports writer over tweet” [Siouxsie Law] “Lessons from Dan Snyder’s Libel Suit” [Paul Alan Levy/CL&P, earlier]
- Litigation rates similar for poor and good nursing homes, researchers find [US News] Effects of medical liability reform in Texas [White Coat, scroll] New York’s Cuomo caves on medical liability plan [Heritage] Sued if you do, sued if you don’t in the emergency room [same]
- “Federal Government Wants to Bully School Bullies, and Demands School Help” [Doherty, Bader, Popehat, Bernstein] New York law firm launches school-bullying practice [Constitutional Daily]
- Mass tort settlements: “The market for specious claims” [S. Todd Brown, Buffalo, SSRN]
- Could Gene McCarthy’s candidacy have survived Arizona elections law? [Trevor Burrus, HuffPo]
Tagged as:
Alex Kozinski,
bullying,
campaign regulation,
emergency medicine,
libel slander and defamation,
mass tort fraud,
nursing homes,
NYC,
sports,
sued if you do,
Texas,
Twitter,
workers' compensation
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).
Tagged as:
Alabama,
emergency medicine
- Couldn’t sue the bees for stinging, but could get a $1.6 million judgment against the emergency room doc [NJLRA]
- Eurodoom: “EU to ban selling eggs by dozen” [Telegraph]
- “Oklahoma’s Unnecessary Law to Ban Citation of Sharia and International Law” [Ku/Opinio Juris, earlier]
- Shortage of generic anesthetics, and what’s behind it [Throckmorton, Great Zs, earlier]
- Hardball litigation tactics contribute to bad odor of consumer debt buyers [Felix Salmon]
- Interview with blogger Carlos Miller (Photography is Not a Crime) [Simon Owens, Bloggasm]
- Conyers “oil spill” bill would slyly expand litigation chances elsewhere [Drug and Device Law]
- Prosecutors deploy hate crimes law against… mortgage fraud? [NYT via PoL] 241 inmates serving life sentences claimed the federal homebuyer tax credit [CNBC]
Tagged as:
debtor-creditor law,
emergency medicine,
Europe,
hate crimes,
international law,
mortgages,
pharmaceuticals
- No answer at 911? “Florida Verdict May Threaten EMS Availability” [White Coat]
- New Orleans politico Steve Theriot drops suit seeking identities of online critics [Times-Picayune and more, NYT "Media Decoder", Slabbed, earlier]
- On a vial of anesthetic: “One patient use only.” Nevada jury finds that warning inadequate to prevent multiple patient use and awards $500 million in punitives [Carter at Point of Law, Abnormal Use] More: Ted at PoL.
- Floodgates to litigation? “Parent Can Sue Ex for Turning Children Against Him” [NJLJ]
- Lawyer who isn’t honest is a threat to the social order: noted Allentown, Pa. attorney gets 6 1/2 years for fraud [Legal Intelligencer, earlier]
- “Another European Prosecution for Insulting Religion” [Volokh; pop star Dorota Rabczewska, Poland]
- A lawyer’s advice: try to get those Rand Paul types off your jury [Turkewitz]
- If SEIU craves respectability, maybe it shouldn’t send mobs to besiege bank execs at their homes [Nina Easton, Fortune, cross-posted from Cato at Liberty; related from PoL last year; more from Big Journalism including role of D.C. police, but note denials on last point]
Tagged as:
emergency medicine,
failure to warn,
family law,
hate speech,
labor unions,
Nevada,
New Orleans
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” 
