Knowledge Library

Narrow Focus Fogs Opportunity for Timely PE Diagnosis

This case study was put together by our partners at CRICO and was written by Melissa A. DeMayo, CRICO Description A 55-year-old patient died of a pulmonary embolism (PE) one week after an urgent care visit. Key Lessons A narrow diagnostic focus can fog the need for additional assessment. Fragmented medical records can challenge multi-specialty care. Clinical Sequence A 55-year-old woman with a history significant for obesity, hypertension, asthma, and anxiety presented to Urgent Care complaining of shortness of breath, hemoptysis, and persistent cough for three days. She reported pain (6-7/10) in her posterior right shoulder and right calf. Nursing...

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Understanding the National Practitioner Data Bank

As a medical professional liability insurer, MIEC has a duty to report settlements and judgments to the National Practitioner Data Bank (NPDB) as well as to state licensing agencies, where applicable. This article will review the history and purpose of the NPDB, who reports, and what must be reported, so that we may better inform our members about this important process. Purpose and Function The National Practitioner Data Bank (NPDB) was established by Congress in 1986 as part of the Health Care Quality Improvement Act, and it is administered by the U.S. Department of Health and Human Services. Its mission...

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Multiple Amputations Follow Prolonged ED Stay

This case study was put together by our partners at CRICO and was written by Katherine Zigmont, BS, RN, CPPS, CRICO Description A 34-year-old male suffered complications of untreated pyelonephritis, including sepsis and multiple amputations, after spending 17 hours in the Emergency Department (ED). Key Lessons Boarding of critically ill patients is associated with increased mortality Abdominal pain coupled with an elevated white blood cell count and fever elevates consideration of urgent testing/imaging Weekend and off shift resources, e.g., a radiologist to read a CT scan, cannot be underappreciated Trainees require vigilant supervision Direct communication between ordering providers and consultants...

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March 2025 Update – Reproductive Care in Idaho

The first few months of 2025 have seen some significant developments in the legal landscape of reproductive care in Idaho following the 2022 ruling in Dobbs v. Jackson and the subsequent prohibition of abortion in Idaho.  For related developments leading up to this year, see Update on Dobbs and Obstetrical Care in Idaho.   Most recent news: January 2025- St. Luke’s Healthcare in Boise, ID filed a lawsuit (St. Luke’s v. Labrador) in which they seek a declaratory judgment that invalidates Idaho’s abortion prohibition, to the extent that it conflicts with the Emergency Medicine Treatment and Labor Act (EMTALA).  As...

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Navigating the Risks and Benefits of AI in Clinical Diagnosis

This resource was made available to MIEC through our partnership with Candello. It was written by Hannah Tremont, MPH Artificial Intelligence (AI) technologies can potentially transform health care services. Although numerous questions and risks remain regarding AI’s integration into health care, the potential benefits of optimizing services and mitigating risks are significant. As most health care systems assess the various risks and advantages of safely and ethically incorporating AI into their operations, Candello examines malpractice claims data where AI may have a significant influence: diagnosis. In a recent Candello webinar discussing AI’s integration into health care services, the presenters discussed...

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