Learning from Lawsuits

Here are some links mentioned in the podcast that may be helpful to listeners: DNR vs AND: https://en.wikipedia.org/wiki/Allow_natural_death Excellent Webinar on POLST: https://www.wsma.org/wsma/education/on_demand_webinars/polst-and-your-practice-tools-to-improve-patient-conversations.aspx?_zs=vlUFd1&_zl=glgWA Serious Illness Conversation Guide: https://www.ariadnelabs.org/wp-content/uploads/2023/05/Serious-Illness-Conversation-Guide.2023-05-18.pdf

This episode talks about the three different ways acute coronary syndrome can present and how to avoid missing unstable angina as a cause of chest pain. Dr. Charles Piltcher and Katie Wyatt NP-C discuss takeaways that can keep each of us from making the same mistakes with our patients.

In this episode, we unpack the case of a 40-year-old woman who came to the Emergency Department with right upper quadrant abdominal pain—an atypical presentation that led her care team away from considering appendicitis. Without the “classic” symptoms, the diagnosis was missed, and she was discharged home—only to return two days later with a ruptured appendix. We explore how cognitive biases, atypical presentation, and time pressures in the ED can impact clinical decision-making. More importantly, we discuss practical strategies to reduce diagnostic error: broadening differentials, recognizing atypical presentations, improving team communication, and strengthening safety-netting at discharge. This episode is a powerful reminder that uncommon presentations of common conditions can test even experienced clinicians—and that small shifts in thinking can make a life-saving difference.

This episode reviews a malpractice case where a psychiatric patient boarded in an ED for over 24 hours was restrained in a prone position, sedated, and left unmonitored, resulting in cardiac arrest and severe brain injury. We discuss failures in monitoring, documentation, restraint policies, and the broader problem of psychiatric boarding, plus lessons for clinicians to prevent similar outcomes. Many thanks to those of you who have donated to help cover the hard costs (about $1000/year) of Med Mal Insights. It means a lot to know that you appreciate the case stories and find them helpful. Donations are always welcome. Here's 3 ways to donate: Zelle: Open your bank's Zelle app using your mobile device. Enter MMI-LFL mobile phone number 2069158593 Venmo: Click this link to Venmo PayPal: Click PayPal and select a donation amount Boarding of Mentally Ill Patients in Emergency Departments: American Psychiatric Association Resource Document. Western Journal of Emergency Medicine, Vol 20 Issue 5 , July 22, 2019. Resources on Behavioral Health Crowding and Boarding in the Emergency Department (ED) Compiled by members of the ACEP Emergency Medicine Practice Committee, September 2019.

In this episode of Medical Manners, we share the story of a woman who came to the emergency department for abdominal pain. She was under the influence, declined care, and left—only to be found dead 12 hours later in a jail cell. This case led to a lawsuit, but more importantly, it raises crucial questions about how we care for our most vulnerable patients. How do we balance compassion and clinical judgment when treating those we might label as “drug seekers” or “frequent fliers”? Join us as we discuss the importance of slowing down, ensuring thorough evaluations, and remembering that every patient—no matter their background—deserves to be seen, heard, and cared for.

Three EMS units went to the wrong address for a cardiac arrest, causing a 12-minute delay. The patient’s heart was restarted, but severe and permanent brain damage left him disabled.The family won a jury verdict after years of litigation. Key takeaways: verify locations, use closed-loop communication, avoid cognitive biases, and remember that every minute counts—time is brain.

Welcome to the latest episode of the Learning from Lawsuits podcast, where hosts Katie Wyatt and Dr. Charles Pilcher delve into the intricate world of medical malpractice with a focus on real cases that offer valuable learning experiences for healthcare providers. In this episode, they discuss a peculiar case involving a failed urethral catheterization in a 47-year-old male patient with acute urinary retention. The case sheds light on the critical distinctions between a mere complication and actual negligence in medical procedures. The episode explores the facts surrounding the case, including the challenges faced during the procedure, the arguments posed by both the plaintiff and defense, and the ultimate decision not to pursue a lawsuit. Dr. Pilcher provides expert insights into the case, emphasizing the importance of proper documentation, understanding known complications, and the necessity of using appropriately sized catheters to avoid creating false passages. Listeners will gain insights into the standards of care in medical practices, the role of proper documentation, and strategies to defend against potential malpractice claims. This episode is an essential listen for medical professionals seeking to better navigate the complexities of their duties while minimizing legal risks.

In today's episode we discuss the story of a man who fell off a ladder, landed on his knee, and walked—or so he thought—into an ER for what seemed to be a straightforward injury. He was diagnosed with a muscle tear… but just three days later, he underwent an above-the-knee amputation. What went wrong? Could it have been prevented? And most importantly—how do we as clinicians, nurses, and providers ensure we never miss something so critical in our own practice? Let’s break down the timeline, the clinical decision-making, the communication gaps, and what this case teaches us about responsibility, humility, and patient safety.

Your clinical judgment doesn’t have to be perfect—but your documentation needs to be. When a lawsuit arises, your notes become your defense. If you didn’t document it, you didn’t think about it—at least in the eyes of the law. In this episode, we break down why thorough medical decision-making documentation is crucial, how it can mean the difference between a defensible case and a devastating lawsuit, and practical tips to ensure your charting reflects the reasonableness of your clinical decisions. Don’t let poor documentation put your career at risk—tune in now and learn how to protect yourself.

In this episode of Medical Malpractice Insights: Learning from Lawsuits, we discuss the heartbreaking case of a 16-year-old male who died of lymphoblastic lymphoma just two days after being discharged from the emergency department. What warning signs were missed? What could have been done differently? We examine the key takeaways from this case to help healthcare providers recognize red flags, improve clinical decision-making, and ultimately prevent similar tragedies in the future. Tune in for an insightful discussion that could save lives.