This my final blog post on this topic and continued from my prior blog post titled, “Emergency Room Standard of Care; Failure to Diagnose and Delay in the Treatment of a Head Injury ~ part two,” with some of the final questions that should be asked and answered in a Medical Malpractice Case in evaluating whether or not the Standard of Care was breached in the Failure to Diagnose and Delay in the Treatment of a Head Injury in the ER:
14.) Q: Did the ER Physician Refer the Patient to a Neurosurgeon?
Why is this important? All patients visiting the ER a second time with a suspected head injury should be referred to a neurosurgeon as soon as possible and detained in the healthcare facility. This is similar to what I described in the case of the young woman who was paralyzed.
In that case it was the Plaintiff’s contention that the ER Standard of Care had been breached since the woman, who had presented in the ER several times with chest pain, was sent home without determining exactly the nature of her chest pain when she should have been admitted to the hospital until there was a definite diagnosis for her chest pain. Instead, she was sent home and when she presented to the ER again and was finally admitted it was too late and she became permanently paralyzed from the waist down.
15.) Q: Was the Patient Admitted and Appropriate Treatment Initiated?
Why is this important? As described herein above, all patients visiting the ER the second time with suspected head injury should be referred to a neurologist as soon as possible. Furthermore, all patients must undergo CT scanning (if not done before) and be admitted for observation, even with an apparently normal CT scan. Neurologic checks must be performed frequently during their in-house observation. If the patient’s condition does not improve, then a repeat CT scan must be performed within 12 to 24 hours.
16.) Q: Was the Patient Intubated?
Why is this important? In addition to airway protection, head-injured patients must be intubated in order to control their ventilation rates and maintain oxygenation.
17.) Q: What Measures were Initiated?
Why is this important? Elevation of the head to 30 degrees significantly reduces ICP in a majority of patients.
18.) Q: Did the ER Physician Order a CT Scan of the Patient’s Head?
Why is this important? As stated previously, a CAT scan is the procedure of choice for emergent assessment of brain/head injury since, as stated herein above, the CAT Scan is rapid, readily available, and reliably shows acute hemorrhages and skull fractures.
19.) Was the Patient Referred to a Neurosurgeon for Further Management?
Why is this important? If a patient is not referred to a neurosurgeon who can track the patient’s progress, then further damage could be caused if the head injury was not detected after following all proper ER procedures, and a neurosurgeon is qualified to perform this follow up on the patient.
These are some, but not all, of the questions that should be asked and answered to determine if the ER Standard of Care was properly followed in the case of a head injury. Even in Question # 14 above, we see a similar standard of admission to the hospital or healthcare facility for further evaluation and observation in a head injury case if the patient presents in the ER a second time.
In the case I discussed in my blog post about the woman who was paralyzed, the patient was not admitted until after several visits to the ER and, as was stated by the experts who testified in that case, by that time it was too late and the young woman was paralyzed as a result of the breach of the ER Standard of Care by releasing her without determining with certainty the cause of her chest pain.
At Julie A. Rice, Attorney at Law, & Affiliates, we are experts in Medical Malpractice cases whether or not said cases involve the ER so please Contact Us for your free legal consultation if you suspect that you or a loved one has been injured or killed due to the negligence of a healthcare provider whether or not it was in the ER or otherwise. We are here to assist you and we look forward to hearing from you soon.