By Stephen C. Morris, MD, MPH | Emergency Medicine Expert Witness

Many complex medical malpractice cases involve multiple physicians, departments, and healthcare facilities. Yet one specialty frequently sits at the intersection of these different areas of medicine: Emergency Medicine.

Emergency physicians routinely evaluate patients before a definitive diagnosis has been established, stabilize critically ill patients, coordinate specialty consultations, initiate treatment, determine the appropriate level of care, and facilitate admission or transfer.

For attorneys evaluating complicated malpractice cases, that broad clinical perspective can be particularly valuable.

I have practiced Emergency Medicine for more than 21 years across academic, community, government, and tertiary-care hospital environments. I am a practicing clinician, currently providing clinical care on the frontline of some of the most complicated clinical environments in emergency care while teaching and supervising the next generation of medical professionals.

The ER Is a Crossroads of Modern Medicine

Emergency physicians do not treat only one organ system or disease category.

During a single shift, an emergency physician may evaluate:

• Neurologic emergencies
• Stroke
• Myocardial infarction
• Sepsis and shock
• Respiratory failure
• Neurologic emergencies
• Surgical complications
• Medication reactions
• Psychiatric emergencies
• Pediatric emergencies
• Geriatric emergencies
• Airway compromise

That breadth is one reason Emergency Medicine can be highly relevant when litigation involves several areas of acute care.

From EMS to Hospital Admission

Emergency physicians also occupy a critical position in the continuum of care.

A patient may arrive through EMS, undergo evaluation in the emergency department, receive emergency treatment, require consultation, and then proceed to an operating room, intensive care unit, inpatient service, or another hospital.

Each transition creates important medical questions.

Was information communicated appropriately?

Was deterioration recognized?

Was the correct specialist consulted?

Was the appropriate level of care selected?

Was the transfer timely?

Did the receiving team receive the necessary clinical information?

Understanding these transitions can be essential when determining where an alleged breakdown occurred.

When a Case Extends Beyond the ER

My expert witness practice reflects the breadth of acute care encountered by an Emergency Medicine physician.

I review cases involving prehospital and EMS care, urgent care, emergency departments, hospital medicine, intensive care, operative and anesthesia complications, interfacility transfers, medical devices and equipment, psychiatric emergencies and restraints, and other complex acute-care events.

I also bring experience in hospital systems, EMTALA, patient safety, quality improvement, risk management, and transitions of care.

Finding the Critical Moment

When thousands of pages of records involve numerous providers, one of the most important tasks is identifying the medically significant decisions.

Where did the patient's condition change?

Was the documentation adequate or contradictory 

Who had the relevant information?

What response was medically reasonable?

Was there an opportunity to alter the course?

Did an alleged departure actually contribute to the outcome?

Emergency physicians make these types of decisions every day.

For malpractice attorneys, an actively practicing Emergency Medicine Expert Witness can help reconstruct the entire acute-care narrative and explain how individual decisions fit into the larger clinical picture.

For objective Emergency Medicine Expert Witness review, visit www.morrismedicolegal.com.