Emergency department crowding and loss of medical licensure: A new risk of patient care in hallways

Robert W. Derlet, Robert M. McNamara, Amin Antoine Kazzi, John R Richards

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)137-141
Number of pages5
JournalWestern Journal of Emergency Medicine
Volume15
Issue number2
DOIs
StatePublished - 2014

Fingerprint

Medical Licensure
Crowding
Hospital Emergency Service
Patient Care
Electrocardiography
Physicians
Emergencies
Hospital Administration
Diabetic Ketoacidosis
Malpractice
Licensure
Patient Safety
Heart Arrest
Embolism
Resuscitation
Dyspnea
Type 2 Diabetes Mellitus
Hearing
Coronary Artery Disease
Autopsy

Keywords

  • Death
  • ED crowding
  • ED hallway care
  • Emergency medicine

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

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.

In: Western Journal of Emergency Medicine, Vol. 15, No. 2, 2014, p. 137-141.

Research output: Contribution to journalArticle

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. In: Western Journal of Emergency Medicine. 2014 ; Vol. 15, No. 2. pp. 137-141.
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