Why Emergency Medicine Physicians Get Sued

Why do emergency medicine doctors get sued, and how do patients get injured? A study of 332 closed emergency medicine malpractice claims by The Doctors Company, the nation’s largest physician-owned medical malpractice insurer, revealed the most common patient allegations in these claims and the most common factors that contribute to patient injury. The goal of the study was to alert physicians and patients to the most common risks and areas for improved patient safety.

According to the study, diagnostic-related issues are the main reason emergency medicine physicians are sued—accounting for 57 percent of claims. Diagnostic problems were also identified as a factor contributing to patient injury, with 52 percent of claims containing issues with patient assessment, such as failure to establish a differential diagnosis and failure to order diagnostic tests.

Emergency medicine doctors face unique challenges—particularly the challenges of diagnosing patients previously unknown to them, encountering a broad range of clinical problems, and pressures of workflow and workload in a busy emergency room. These tips can help emergency medicine doctors avoid diagnostic errors:
• Avoid first-impression or intuition-based diagnoses.
• Complete a thorough differential diagnosis for each patient.
• Use diagnostic prompts when completing your differential diagnosis. Because emergency medicine doctors face such a broad range of patients and potential diagnoses, these prompts can help ensure all diagnoses are considered.
• Document your differential diagnosis. This step is especially important to reduce potential liability risks.
• Make sure that all specialists who are called to evaluate emergency department patients receive a comprehensive summary of the clinical picture, including history, physical findings, and diagnostic studies. During the handoff discussion, it should be clear who has responsibility for review and follow-up of all test results and diagnostic studies.
• Practice effective handoffs. Make sure there is interactive communication between physicians when the care of a patient is being handed off so they can determine each physician’s responsibilities. Staff must have a clear understanding of which physician is in charge of the patient’s care.

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