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Claims Lessons

The experience of others is often the best teacher. In medicine, as in life, we often learn the most from the insights of those who have ‘been there’. That’s why claims lessons are the training tool of choice.

Our claim files are packed with scenarios to avoid and lessons to learn. The claims lessons below all come from real claims that we’ve seen and defended (though some facts have been altered to protect the confidentiality of the parties). Each claims lesson is presented in a brief, simple format that concludes with practical “learning points” that nearly every practice can relate to.

Policyholders and staff alike are invited to learn from our experiences.

These claims lessons are presented for educational purposes only and are not intended as legal advice. Readers should consult qualified legal counsel to address specific legal issues.

Specialty		Title
Anesthesiology		Anesthesiologist Innocently Caught in a Hospital Employee’s Drug Diversion Scheme Tells Her Story
		Pain Mismanagement: Plaintiff Victory Attributed to Problems with Poor Record Documentation and Inconsistent Prescribing Practices
		Patient succumbs to a preventable anesthesia respiratory event
		Risk of high spinal anesthesia following failed epidural block for cesarean delivery
		Suit Alleges Medical Negligence for Failure to Maintain Written Protocols for Administration of Controlled Substances in the Absence of Written Orders in the PACU
Cardiology		Medication Risk/Benefit Analysis
		Patient Suffers Fatal Arrhythmia Linked to Outpatient BETAPACE Prescription
Cardiology/ Primary Care		Failed Communications in the Medical Office Lead to and “Alleged Delay in Treatment”
		Failure to Diagnose Acute Coronary Syndrome during Office Visit, $1M Verdict - NEW
		Weak On-Call Handoff and Discharge Instructions Botch Patient's Coumadin Therapy.
Dermatology		Absence of a Test Tracking System Contributes to a Delay in Diagnosis of Squamous Cell Carcinoma
Emergency Medicine		Atypical Chest Pain –Work ‘Em up or Sign ‘Em out?
		Could Antibiotics Upon Presentation Have Prevented Asplenic Patient's Death?
		The Importance of Clinical Evaluation in Managing “Atypical“ Chest Pain
Gastroenterology		Reglan & Tardive Dyskinesia: Black Box Warning May Not Be Enough to Protect Patients
Multispecialty		Anesthesiologist Innocently Caught in a Hospital Employee’s Drug Diversion Scheme Tells Her Story
		Black Box Warning + Inadequate informed Consent = Indefensible Claim
		Concierge Medicine-No Guarantee against Failure to Diagnose Lung Cancer
		Documentation and Referral Issues Snag Pulmonologist in Prostate Cancer Case
		Failed Physician-Nurse Communication, Post-Op Sleep Apnea, Death
		From Chronic Problems to an Acute Dilemma
		Gadolinium-induced NSF Claim Resolved in Favor of the Plaintiff
		Inmate’s Death Case Results in Large Payout
		Multiple Providers Named in Failure to Diagnose Case
		One of the Top 10 Health Technology Hazards: Cross Contamination from Flexible Endoscopes
		Patient Death Blamed on Negligent Opioid Prescribing, $875,000 Awarded - NEW
		Patient Monitoring/Medication Management
		Physicians Sued for Failing to Report Suspicions about Colleague Who Was Molesting Patients - NEW
		Positive HIV Result Drops through the Cracks of a “Flawless” Office System
		Settlement Agreement reached in 17 month Delay of Melanoma Diagnosis The Case
		Treatment Delayed Despite Multiple Visits and Phone Calls
		Wrongful Death Suit Alleges Abnormal X-Ray Results Never Reported
Neurology		Gadolinium-induced NSF Claim Resolved in Favor of the Plaintiff
OB/Gyn		Lack of Midlevel Supervision Contributes to Shoulder Dystocia Claim.
		Medically Complex GYN Patient Alleges Unnecessary Surgery after Experiencing Surgical Complications.
		Obstetrician Faces the Perfect (on-call) Storm
		"Time-Out" Procedure Fails; Patient Gets an Unwanted Bilateral Oophorectomy
Orthopedics		Compartment Syndrome Case Study, the Sequelae of a Delayed Diagnosis
Pathology		Pathology Error Results in Alleged Delay in Diagnosis of Malignant Melanoma
		Settlement Agreement reached in 17 month Delay of Melanoma Diagnosis The Case
Pediatrics		Delayed Diagnosis of Rocky Mountain Spotted Fever in a small child results in Catastrophic Injury
		Physicians Sued for Failing to Report Suspicions about Colleague Who Was Molesting Patients - NEW
Primary Care		Acute Leukemia Fatal after Failure to Address Abnormal CBC and Narrow Diagnostic Focus
		Copy and Paste Documentation Creates A Problematic Defense
		Could Antibiotics Upon Presentation Have Prevented Asplenic Patient's Death?
		Delay in Diagnosis of Colorectal Cancer Results in Advanced Metastatic Disease and Ultimate Death of the Patient
		Failure to Diagnose Acute Coronary Syndrome during Office Visit, $1M Verdict - NEW
		Holiday weekend + New Hospital Computer System = High Risk Patient Discharge
		Meningitis: Communication Issues Result in a Delay in Diagnosis/Delay in Treatment
		Reglan & Tardive Dyskinesia: Black Box Warning May Not Be Enough to Protect Patients
		Simple Prescription Mistake Leads to Tragic Outcome
Radiology		Anesthesiologist Innocently Caught in a Hospital Employee’s Drug Diversion Scheme Tells Her Story
		Gadolinium-induced NSF Claim Resolved in Favor of the Plaintiff
		Importance of Accurate, Timely and Effective Communication of Abnormal Imaging Findings in the Emergency Department Setting
Surgery		Management By PA Alone Proves Inadequate in Treating Wound Infection
		Surgical Fires: Reducing the Risk of Patient Injury
		"Time-Out" Procedure Fails; Patient Gets an Unwanted Bilateral Oophorectomy