Beyond the Signature – Strategies to Improve Informed Consent
This resource was made available to MIEC through our partnership with Candello. It was written by Hannah Tremont, MPH Following an unsatisfactory outcome from finger surgery, a 38-year-old patient filed a malpractice claim alleging the wrong procedure was performed. However, thorough documentation of informed consent discussions supported the surgeon’s care, leading to a defense verdict at trial. A 25-year-old patient underwent Gamma Knife radiosurgery and suffered post-operative hearing loss in the left ear. Initially planned for the right ear, the procedure was intentionally changed to the left, but no documentation of informed consent or discussions about this change was recorded....
Candello Releases Benchmarking Report on Documentation Risks
This week, Candello released their 2024 Benchmarking Report entitled For the Record: The Effect of Documentation on Defensibility and Patient Safety. The report was written to provide physicians, APPs and nurses with practical insights and recommendations to improve their documentation practices and reduce their personal malpractice risk and enhance the safety of their patients. While the report is primarily geared toward doctors and mid-level providers, it could be beneficial for anyone who is responsible for managing documentation. Here are some key findings of the report: 20% of cases involve at least one documentation failure. Documentation issues more than double the...
Diagnosis of Aortic Dissection Delayed by Mismanagement of Imaging Orders
This case study was made available to MIEC through our partnership with CRICO. It was written by Jack Hoffman CRICO Description A 60-year-old male seen in the ED for acute severe epigastric pain suffered a hypoxic brain injury and spinal paraplegia after mismanagement of imaging orders delayed the diagnosis of an aortic dissection. Key Lessons Instructions for patients who call with potentially life-threatening conditions should reflect the urgency (e.g., “get to the nearest ED, immediately”) Abnormal vital signs merit a higher ESI (emergency severity index). Diagnostic study orders should prioritize immediate life threats as well as the likelihood of possible...
This case study was made available to MIEC through our partnership with CRICO. It was written by Gretchen Ruoff, MPH, CPHRM, CRICO Margaret Janes, RN, JD, CRICO Description Following surgery for rectal prolapse—which involved a malfunctioning stapling device—a 53-year-old male experienced complications and required additional surgery. Key Lessons Policies for trial device assessment must ensure they prevent the use of an unapproved trial device. Comprehensive pre-operative planning protects patients and providers. Clinical Sequence A 53-year-old man with a long-standing history of rectal prolapse presented for elective sigmoid resection with rectopexy. The patient underwent a pre-operative surgical office consultation weeks prior...
Brain Damage Follows Inattention to Newborn’s Jaundice
This case study was made available to MIEC through our partnership with CRICO. It was written by Annette Roberts, CRICO Description A newborn developed brain damage after indications of hyperbilirubinemia went unattended. Key Lessons Mothers of newborns rely on their caregivers to give thorough attention to signs or symptoms of identified risks Non-adherence to a hospital policy that addresses an extraordinary clinical risk is indefensible Lack of an adequate response to this mother’s specific concerns and her baby’s clearly reported worsening condition risks preventable harm Clinical Sequence Immediately post-delivery (cesarean), the mother (G3P3) and newborn girl were noted to have...