If it was that subtle and difficult to pick up, I don’t think the plaintiffs would have been awarded $3M. It was probably gross negligence and malpractice.
Hard diagnoses are hard. That’s why we train like we do. That’s why this NP/PA independence push is so disturbing to us. We see all the mistakes that WE make and think “how could ANYONE with 1/10 of the training think they are ready for this?”
I caught one case that I almost sent home. If you looked at this kid and said, "sick or not sick", you would have said "not". When I spoke with the CC fellow at CHP, she just called it "incomplete penetrance", and was more than happy to take the transfer.
Early Kawasaki will almost always be missed as a URI or similar viral illness. Just remember if fever is going on for a week: it’s either some weird **** or the mom is bad at dates.
If NP’s want to work independently, I say them let. Let them practice “at the top of their license”. Then let these cases pile up. That’s the only way that politicians, insurance companies, and corporate suites will change. Otherwise, refuse to loosely supervise them or keep them on a very short leash. You’re right that the lawyers are going to come after you even if you didn’t see the patient and only signed off on the charts. That’s why I refuse to loosely supervise anyone who is attached to my license. Of course, doing mostly diagnostic radiology affords me that luxury. As I’ve commented in multiple prior posts, it makes no financial sense to widely adopt midlevels in diagnostic radiology and that’s why midlevel encroachment is not an issue in radiology.
This 👆 part I agree with this 100%. I think you and I mostly agree on the mid-level vs. physician topic.
I think they sued the health system. The PA if you look him up is still working there.
www.4stateslaw.com
Some states have limits on awards based on expected economic losses, that may have been an attempt to limit the hit. As an aside, even at my most burnt out, I don't think I could have sat in front of a grieving family and explained how their child's death ultimately saved them money. That expert witness is a psychopath.I think they sued the health system. The PA if you look him up is still working there.
“CoxHealth admitted to no wrongdoing and refused to offer any compensation to the family. Furthermore, in a particularly insensitive effort to sway the jury, CoxHealth had an economist testify that the “cost” of raising a child should be considered and that Kyler’s tragic and untimely death actually spared the family the expense of raising him.”
If Nobody is Held Accountable, How do Things Change? | JVM Law
Recent $3M+ Verdict Holds CoxHealth Accountable. When one-year-old Kyler George woke the morning of June 5, 2017, his mother, Kassie McAtee, thought he seemed unwell. He looked pale, felt cold and clammy, and seemed lethargic. Kassie brought Kyler to the Urgent Care at CoxHealth Branson...
It's the policy of med-mal defense attorneys and insurance companies any time they can get out of a death case for $100,000 or less, to take it and run, regardless of the merits of the case. Asking how I know buys an instablock.
I think they sued the health system. The PA if you look him up is still working there.
“CoxHealth admitted to no wrongdoing and refused to offer any compensation to the family. Furthermore, in a particularly insensitive effort to sway the jury, CoxHealth had an economist testify that the “cost” of raising a child should be considered and that Kyler’s tragic and untimely death actually spared the family the expense of raising him.”
If Nobody is Held Accountable, How do Things Change? | JVM Law
Recent $3M+ Verdict Holds CoxHealth Accountable. When one-year-old Kyler George woke the morning of June 5, 2017, his mother, Kassie McAtee, thought he seemed unwell. He looked pale, felt cold and clammy, and seemed lethargic. Kassie brought Kyler to the Urgent Care at CoxHealth Branson...
I missed a Kawasaki's diagnosis recently that was also missed by a 20+ year PEM attending (kid did fine). Given the rarity/non-specific nature of it I don't know how much I can really blame this on mid-level training.
Yup, easy to miss. The kid of one of my EM attendings had it. She missed it as did their pediatrician and a few other folks before the kid got really sick...
Kawasaki's is a tough pickup, especially early on. In the era of vaccinations, there should be really few times that you send a kid home and they die within hours. Don't know if this kid had an atypical case and looked great until he dissected a coronary and went into a lethal arrhythmia. But I do know that every kid I see with a fever that doesn't have a clear source on initial visit gets instructions about a follow up visit if fever duration starts creeping into Kawasaki territory.
Agreed. But again let’s not fall into the mid level trap. We are physicians and hold ourselves to the highest standards so we are allowed to be forgiving. Mid levels use “anyone could have missed that” just justify their 500 hours of clinical training.
"Any mid-level would have missed that" is a more accurate statement
I thought that that sounded really, really familiar!
D.H. Lawrence, Lady Chatterley's Lover
I posted that 20 posts before you, in the very same thread. I don't know where I heard it, but I've never read any D.H. Lawrence in my entire life. Did you ever read "Who's Cribbing?", by Jack Lewis?
If physicians with 15000+ hours of training under their belt miss lots of things, why DO we even allow midlevels with <500 hours to even touch patients, let alone "practice healthcare" independently.
