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TABLE OF CONTENTS

Volume 1 No. 1 January 2013

Medical Malpractice Case 1 Medical Malpractice Case 2 Medicolegal Topics The Anatomy of a
 Medical Malpractice Case
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VOLUME 1 NO. 1 JANUARY 2013

MEDICAL MALPRACTICE CASE I

A four-year-old girl presented to the emergency department with fevers, nausea, vomiting, neck pain, headache, and lethargy. The patient was incorrectly triaged by a paramedic, who was not permitted to examine the patient; he missed critical physical exam findings of stiff neck, photophobia, and lethargy. The child was given an incorrect acuity rating, which delayed her evaluation by the emergency medicine physician.

The emergency medicine physician examined the patient two hours later. The patient was noted to have nuchal rigidity on physical exam. The physician suspected bacterial meningitis and performed a lumbar puncture without first obtaining a computer tomography of the head. Spinal fluid sprayed out during the procedure indicating elevated cerebral spinal pressure. MORE

MEDICAL MALPRACTICE CASE II

An 18-year-old college freshman female who was taking phenelzine (Nardil) for depression presented to the emergency room with complaints of fever, agitation, intermittent mental status changes, and unusual jerking body movements. Her past medical history was unremarkable except for depression. She denied any illicit drug use. The resident physicians found her skin flushed, eyes dilated and rolling. They also noted a thrashing, compulsive extremity movement alternating with moments of calmness. After the residents discussed the case by telephone with the attending physician, she was admitted with the diagnosis of "viral syndrome with hysterical symptoms." Throughout the night and early morning the patient became increasingly agitated. The thrashing caused her peripheral intravenous line to disconnect twice and she tried to climb out of bed. The resident, over the phone, ordered physical restraints to prevent the patient from hurting herself and prescribed an injection of haloperidol (Haldol) to aid in calming her down.