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Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways

We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED) crowded to 250% over capacity. His initial symptoms of shortness of breath and feeling ill for several days were evaluated with chest radiograph, electrocardiogra...

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Autores principales: Derlet, Robert W., McNamara, Robert M., Kazzi, Amin Antoine, Richards, John R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966445/
https://www.ncbi.nlm.nih.gov/pubmed/24672599
http://dx.doi.org/10.5811/westjem.2013.11.18645
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author Derlet, Robert W.
McNamara, Robert M.
Kazzi, Amin Antoine
Richards, John R.
author_facet Derlet, Robert W.
McNamara, Robert M.
Kazzi, Amin Antoine
Richards, John R.
author_sort Derlet, Robert W.
collection PubMed
description We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED) crowded to 250% over capacity. His initial symptoms of shortness of breath and feeling ill for several days were evaluated with chest radiograph, electrocardiogram (EKG), and laboratory studies, which suggested mild diabetic ketoacidosis. His medical care in the ED was conducted in a crowded hallway. After correction of his metabolic abnormalities he felt improved and was discharged with arrangements made for outpatient follow-up. Two days later he returned in cardiac arrest, and resuscitation efforts failed. The autopsy was significant for multiple acute and chronic pulmonary emboli but no coronary artery disease. The hospital settled the case for $1 million and allocated major responsibility to the treating emergency physician (EP). As a result the state medical board named the EP in a disciplinary action, claiming negligence because the EKG had not been personally interpreted by that physician. A formal hearing was conducted with the EP’s medical license placed in jeopardy. This case illustrates the risk to EPs who treat patients in crowded hallways, where it is difficult to provide the highest level of care. This case also demonstrates the failure of hospital administration to accept responsibility and provide resources to the ED to ensure patient safety.
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spelling pubmed-39664452014-03-26 Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways Derlet, Robert W. McNamara, Robert M. Kazzi, Amin Antoine Richards, John R. West J Emerg Med Diagnostic Acumen We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED) crowded to 250% over capacity. His initial symptoms of shortness of breath and feeling ill for several days were evaluated with chest radiograph, electrocardiogram (EKG), and laboratory studies, which suggested mild diabetic ketoacidosis. His medical care in the ED was conducted in a crowded hallway. After correction of his metabolic abnormalities he felt improved and was discharged with arrangements made for outpatient follow-up. Two days later he returned in cardiac arrest, and resuscitation efforts failed. The autopsy was significant for multiple acute and chronic pulmonary emboli but no coronary artery disease. The hospital settled the case for $1 million and allocated major responsibility to the treating emergency physician (EP). As a result the state medical board named the EP in a disciplinary action, claiming negligence because the EKG had not been personally interpreted by that physician. A formal hearing was conducted with the EP’s medical license placed in jeopardy. This case illustrates the risk to EPs who treat patients in crowded hallways, where it is difficult to provide the highest level of care. This case also demonstrates the failure of hospital administration to accept responsibility and provide resources to the ED to ensure patient safety. Department of Emergency Medicine, University of California, Irvine School of Medicine 2014-03 /pmc/articles/PMC3966445/ /pubmed/24672599 http://dx.doi.org/10.5811/westjem.2013.11.18645 Text en Copyright © 2014 the authors. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Diagnostic Acumen
Derlet, Robert W.
McNamara, Robert M.
Kazzi, Amin Antoine
Richards, John R.
Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways
title Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways
title_full Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways
title_fullStr Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways
title_full_unstemmed Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways
title_short Emergency Department Crowding and Loss of Medical Licensure: A New Risk of Patient Care in Hallways
title_sort emergency department crowding and loss of medical licensure: a new risk of patient care in hallways
topic Diagnostic Acumen
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966445/
https://www.ncbi.nlm.nih.gov/pubmed/24672599
http://dx.doi.org/10.5811/westjem.2013.11.18645
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