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HPS LEGAL ALERT: COMMON FAILURES TO DIAGNOSE IN THE EMERGENCY ROOM

By James S. Haliczer and Kenneth J. Miller

November 16, 2021

Emergency Room staff are tasked with addressing a wide variety of ailments, in a fast-paced environment. Because of these factors, emergency rooms have higher error rates than many other areas and these errors can result in serious and tragic consequences.

Some ailments that are commonly missed in the Emergency Room include:

  • Heart attacks
  • Blood clots
  • Strokes
  • Infections
  • Complications from bone fractures

There are two common situations when Emergency Room misdiagnoses occur. The first, a dual diagnosis, is when signs and symptoms with which the patient presents can lead to two or more equally likely diagnoses.  The second is what we like to call the “unicorn” situation. This would be a case where the condition that needs to be diagnosed is rare and not likely to have been encountered often, if at all, by emergency room doctors.

The Dual Diagnosis Situation

The dual diagnosis situation, where a misdiagnosis results from two conditions with similar signs and symptoms, is a very common situation. A lawyer’s inadequate investigation or not having selected the right expert consultants could impact uncovering the validity of the case.

  • For example, when the victim suffers from broken bones that Emergency Room staff treats, but they miss the coinciding development of Compartment Syndrome. Victims of Compartment Syndrome can experience long-term neuromuscular deficits or even amputation. Medical experts agree that this syndrome is difficult to diagnose in the Emergency Room setting.
  • Another common situation is with cardiac cases — where the patient is having a heart attack and is thought to be having gastroesophageal reflux instead. This can lead to tragic circumstances, such as patients sent home only to die in the parking lot after a heart attack was mistaken for heartburn.

The Unicorn Situation

The unicorn is a rare circumstance. There just aren’t that many wildly unusual cases that present for the first time in an Emergency Room. But again, when an attorney is dealing with these types of possible cases, inexperience with requesting a thorough investigation or a reluctance to hire specific types of expert consultants can result in a failure to recognize when a potential client is dealing with a valid Emergency Room medical malpractice situation.

  • Valid cases have arisen relating to Wilson Disease, a rare disease with a significant lack of awareness by physicians. It requires extremely targeted testing, such as genetic testing, etc. If not uncovered soon enough and misdiagnosed as another condition, the victim can suffer long-term side effects such as permanent neurological dysfunction.
  • In the past meningitis in children was another type of health issue that was frequently missed by doctors. And even now, with major advances in education and Emergency Room detection procedures, meningitis is still one of the most common pediatric illness subject to misdiagnosis.

The Legal Challenges of ER Cases

The challenge when bringing a claim under either of these scenarios is that under Florida law, health care workers providing emergency services are not held liable in certain situations. This is known as the Good Samaritan Act.

That is why, when handling these types of cases, it is important to have research and expert opinions on hand to be able to ask the right questions. Was this a situation where no one should have expected the emergency services staff to make a diagnosis? Did the staff fail to act appropriately and created an unreasonable risk of injury that impacted the patient? For instance, did the Emergency Room physician make sure the specialist they requested conduct their follow up in a timely basis (ex. delays in diagnosis occur in up to one quarter of aneurysm victims)?

Key Takeaways

Consultation with an attorney with a deep bench of knowledge of the law (complicated state malpractice laws or specialty laws like The Good Samaritan Act), familiarity with standard Emergency Room procedures, familiarity with conducting comprehensive investigations, and access to a wide variety of seasoned experts, will impact the end result of uncovering when true Emergency Room medical malpractice occurred.

If you are dealing with a possible Emergency Room medical malpractice case and would like to discuss your options, please contact Jim Haliczer, Ken Miller, or any member of our Haliczer Pettis & Schwamm legal team.

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