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Overdose or Poor Documentation? Oct 17, 2023

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The patient’s family alleged that improper management of the patient under anesthesia resulted in cardiorespiratory arrest, permanent brain damage, and a persistent vegetative state. While the cause of the patient’s cardiac arrest is uncertain, the CRNA failed to note which medications and doses were administered during the procedure, and the case was settled for more than $1 million.

Response to Charges of Discrimination can Help or Hurt a Hospital, Any Employer Jul 12, 2023

Show notes

When hospitals and medical practices face charges of discrimination from employees, the consequences can include litigation, large payments, morale problems, and less quality care for the patients they serve. How an employer responds can make all the difference in outcomes. Based on closed claims in the Harvard medical system, two cases illustrate that point. We interview Megan Kures, of Hamel, Marcin, Dunn, Reardon and Shea, who offers some principles to follow.

Slow to Diagnose Endocarditis After Repeat Visits Apr 04, 2023

Show notes

One thing that seemed to be missing in this particular evaluation was a formal differential diagnosis that may have been present in the physician’s brain, but wasn’t documented, and there’s no evidence that it was really thought about.

Signs of Bias in Rejected Request for Accommodation Dec 12, 2022

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Boston Attorney Megan Kures explains how a hospital should respond to a request for accommodation. Tip: it shouldn’t be a knee-jerk no, and be sure to involve HR from the start.

Health Payment Reform Act: Rules to Protect Providers Sep 27, 2022

Show notes

After a state medical error disclosure and apology law went into effect in November 2012, health providers in Massachusetts have protections and rules to follow.

Cardiac Event Mismanaged in ED Apr 13, 2022

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An otherwise healthy 50-year-old woman presented to the Emergency Department with atypical chest pain. Discharge the next morning was followed by death.

Woman’s Stroke Progressed in ED without Intervention Nov 16, 2021

Show notes

The patient needed to be evaluated by a stroke team and a neurologist promptly to decide whether any treatment was indicated or possible. Triage should be the same whether the ER was empty or overcapacity.

Surgery Change Needed Better Consent Aug 06, 2021

Show notes

The goal was to treat uncontrolled pain from tumors but the patient was left with unexpected hearing loss. The patient sued when she claimed the surgeon changed the side of the operation without consulting her. For ideas that might help prevent these negative outcomes, we talk with Douglas Smink, MD, MPH, an associate medical director for CRICO and the Chief of Surgery at Brigham and Women's Faulkner Hospital.

Lack of Preparation, Safety Culture, Contributed to Loss of Baby Jun 02, 2021

Show notes

This OB patient’s risk factors were not adequately considered, and the team’s failure to follow protocols and secure back-up contributed to a lawsuit and a settlement of over $1 million.

Unclear Discharge Instructions, Patient Loses Foot Feb 28, 2021

Show notes

In a lawsuit naming the Emergency Medicine physician and a nurse, the patient alleged that a dressing was applied too tightly, compromising the circulation and resulting in a gangrenous foot, requiring amputation. Despite an eventual defense verdict, some lessons show how to prevent this bad clinical result and a five-year legal ordeal.

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