MedMal Insider

Latest Episodes:

Was This Primary Care Nurse Practitioner Too Rushed? May 17, 2016

Show notes

The crux of the case is that a detailed history and physical exam were not performed, and so a broad differential was not considered before the patient suffered a stroke.

Troubled Brew: Multiple Providers, Disjointed Care, Lost Kidney Function Feb 02, 2016

Show notes

In this case, we see issues that can arise in care that takes place across multiple institutions and providers, especially when the patient is self-referring. This patient was left with seriously-impaired kidney function, and he alleged a delay in diagnosis. Joining us is Dr. Carla Ford, who reviews medical malpractice claims for CRICO.

Spine Surgery: Someone Should Have Said ‘Time Out’ Sep 02, 2015

Show notes

This review of a closed malpractice claim shows the risks when communication before, during, and after a surgical complication goes awry.

Diagnostic Dropped Ball: Nobody Followed Up on Lung Nodule May 07, 2015

Show notes

After a referral visit to a pulmonologist to follow up on a worrisome CT, none of the three parties—the PCP, the patient, and the pulmonologist—ever addressed the issue of the lung nodule again. The patient saw her primary care doctor several times for check-ups and minor issues over the next several years. The patient never returned to see the pulmonologist, and was not explicitly told by either doctor that she might have cancer. Four years after her visit with the pulmonologist, the patient became symptomatic from lung disease and was found to have inoperable cancer, metastatic to cervical spine. She died within months of her diagnosis.

Unfair But So What? Trial for MD After Patient Skips Screening Mar 03, 2015

Show notes

During an initial physical for a new 38-year-old female patient, the PCP noted a normal breast exam, and recommendations for a screening mammogram and colonoscopy due to family history of colon cancer. A mammogram was never done, although the patient returned to this physician practice a dozen times over the next several years for episodic care. Then she presented with a self-identified lump, followed by a cancer diagnosis. Dr. Carla Ford discusses the patient safety and risk management implications.

Asplenic Patient Disabled after Providers Overlooked Infection Risk Mar 25, 2014

Show notes

Despite multiple visits to her PCP, a 30-year-old woman without a spleen was never given prophylactic antibiotics or told the risks of a high fever. A mishandled telephone triage delayed her trip to the ER, and the resulting pneumococcal sepsis led to permanent disabilities and a $1 million-plus settlement.

Missed Steps Delay Breast Diagnosis Oct 31, 2013

Show notes

Even though the patient identified a lump on her breast, it took more than a year to diagnose cancer. Family history-taking and proper imaging were lacking. CRICO interviews one of the authors of a Harvard breast care management algorithm, Michelle Specht, MD, to consider how following such a guideline could have helped the gynecologist and radiologist—and ultimately the patient.

A Missed MI Diagnosis and Death After Office Visit Jul 25, 2013

Show notes

As in many missed MI cases, the primary care physician did not order an EKG. Thomas Sequist, MD, of Atrius Health, describes where some of these cases typically go wrong, and how using a Framingham Risk Score can help with the evaluation process in the office practice.

Misread of Data Slowed Response, Hurt Patient Apr 17, 2013

Show notes

Fetal heart rate tracings indicated earlier intervention after prolonged induction of labor. The obstetrician and nurse midwife were faulted for not working more closely together.

Patient Loses Finger after Medication Error in ER Feb 25, 2013

Show notes

Medication error in the ER was preventable. Culture and communication problems compounded an error that required several surgeries and amputation.

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