Posts Tagged ‘emergency medicine’

“Alarm fatigue”

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.

Medical roundup

  • “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]

NYT vs. White Coat on undiagnosed sepsis case

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.

Medical roundup

  • 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]

Medical roundup

Lawyer: ER “simply not permitted to discharge” without ruling out life-threatening conditions

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.

March 7 roundup

  • 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]