So you may be sued!!!

Dr Kingsly Robert Gnanadurai MD, MBA, PGDMLE

HOD - Emergency Medicine
Bangalore Baptist Hospital

Proportion of Physicians Facing a Malpractice Claim Annually

 Emergency

medicine physicians are

more prone to be sued for diagnosisrelated issues than many other
specialists because they treat
patients who are unknown to them
and who have a broad range of
clinical problems.

Doctors company study on claims

from Emergency Medicine( 200713)
The four most common patient allegations:
57% Diagnostic-related issues

Failure to establish a differential diagnosis

Failure to address available clinical information.

Failure to order diagnostic tests

13% Improper management of treatment

Failure to stabilize a patient's neck following an

accident

Failure to explore wounds

5% Improper performance of a treatment or procedure

Intubation.

Central line insertion/IV insertion

Suturing

Imaging procedures
3% Failure to order medication

Not initiating fibrinolytic therapy in acute MI or

Stroke

Not initiating on Antibiotics

Top six factors leading to patient injury

Doctors company study on claims from
Emergency Medicine

Inadequate patient
assessment

52

Failure to establish a
differential diagnosis
Failure to address available
clinical information.
Failure to order diagnostic
tests
Premature discharge

Top six factors leading to patient injury

Doctors company study on claims from
Emergency Medicine

Patient Factors

21

Obesity
Nonadherence to
treatment plan
Nonadherence to
follow-up

Top six factors leading to patient injury

Doctors company study on claims from
Emergency Medicine

Communication
among providers

17 %

Failure to
communicate
Failure to review
medical chart
Poor professional
rapport/conduct

Top six factors leading to patient injury

Doctors company study on claims from
Emergency Medicine

Communication between
patient/family and
providers

14 %
Poor rapport
Inadequate
follow-up
instructions
language
barriers

Top six factors leading to patient injury

Doctors company study on claims from
Emergency Medicine

Insufficient or lack of
documentation

13 %

Failure to record
Failure to review
the chart

Top six factors leading to patient injury

Doctors company study on claims from
Emergency Medicine

Workflow and workload

12%

Fewer staff or
services available
on a weekend,
night, or holiday
Long wait time for
patients with
abnormal vital
signs or chest pain

Insisting for Money Causing Death in Emergencies

Declared as Negligent

In

Pravat Kumar Mukerjee vs. Ruby General Hospital

The

case of a young student whose motorcycle was dashed by a bus in

Kolkata.

He

was brought to the Respondent hospital but the treatment was not
continued as Rs.15, 000 were not immediately paid.The boy died.

The

Petitioner was awarded a compensation of ten lakhs. The National

consumer Commission held that in emergencies the doctor was bound to
treat the patient and could not insist on delaying treatment until the fees
were paid.

Treat

patients in emergency as this falls under Right to Life Article 21

of constitution.

Mihir Desai, Dipti Chand. Healthcare Case Law in India. Right to Emergency Health Care. August 2007:
37-45.

J Indian Acad Forensic Med.

July-September 2013, Vol. 35, No. 3 ISSN 0971-0973 288

Case Report Death due to

Medical Negligence: A Case
Report
*N. Srinivasaragavan, **Kadhirazhagan, ***K. Thunderchief, ****J.
Magendran

Tips to help Emergency Physicians

to avoid getting sued
Avoid first-impression or intuition-based

diagnoses.
Follow protocol and algorithms when
completing your differential diagnosis
Document your differential diagnosis.
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 and the same is documented
Practice effective handovers.
It should be clear who has responsibility for
review and follow-up of all test results and
diagnostic studies.

Thank you