Board Certified Emergency Medicine Physician

Sample Case Descriptions

Sepsis and Endocarditis

An adult male was evaluated and discharged from an ER for fever and weakness. Blood cultures resulted positive for gram negative bacteria but the patient was never notified. The patient was subsequently diagnosed with sepsis and endocarditis and had a complicated hospital course. The issue in question was whether the initial provider, and subsequently the hospital, met or breached standard of care in their evaluation, treatment, and disposition of the patient.

Necrotizing Fasciitis and Septic Shock

An adult male developed a skin/soft tissue infection while incarcerated, possibly related to heroin injection, and died several days later due to septic shock. The issue in question was whether the jail medical staff adequately evaluated and treated his infection.

Appendicitis

An adult male presented for abdominal pain and was evaluated and discharged. Several days later he was admitted for ruptured appendicitis. The issue in question was whether the ED provider met the standard of care in his/her evaluation and disposition of the patient at the first visit.

Spinal Epidural Abscess (SEA)

An adult female patient presented to multiple ER providers with back pain and lower extremity weakness. She was ultimately taken to emergent surgery for SEA. This issue in question was whether the initial providers met or breached standard of care in their evaluation and disposition of the patient.

Ectopic Pregnancy

An adult female presented with abdominal pain and nausea/vomiting. She was evaluated and discharged from an ER. Several days later she died from ruptured ectopic pregnancy. The issue in question was whether the initial provider met or breached standard of care in their evaluation and disposition of the patient.

Aortic Dissection

An adult male presented to an ER with chest pain and was evaluated and discharged. He died several days later from an aortic dissection. The issue in question was whether the initial provider met or breached standard of care in their evaluation and disposition of the patient.

Abdominal Compartment Syndrome – Ischemic Bowel

An adult female presented to an ER with abdominal pain and was evaluated and discharged. Several days later she re-presented and was taken for emergency surgery and had significant bowel resected (removed). The issue in question was whether the initial provider met or breached standard of care in their evaluation and disposition of the patient.

Pediatric Testicular Torsion

A school-age male presented to an ER with abdominal pain and constipation and was evaluated and discharged. He returned a day later and was taken to emergent surgery for testicular torsion. The issue in question was whether the initial provider met or breached standard of care in their evaluation and disposition of the patient.

Blunt Head Trauma with Subsequent Subdural Hematoma and Intracranial Hemorrhage

An adult male suffered minor head trauma and was evaluated and discharged from an ER. Several days later he was found unconscious and ultimately died from intracranial hemorrhage. The issue in question was whether the initial provider met or breached standard of care in their evaluation and disposition of the patient.

Cerebrovascular Accident (CVA) / Stroke

An adult patient presented to ER with neurologic symptoms and was evaluated and discharged. Several days later they were diagnosed with a subacute stroke. The issue in question was whether the initial provider met or breached standard of care in their evaluation and disposition of the patient.

Acute Myocardial Infarction in the waiting room

A patient presented to the ER with chest pain and died shortly after arrival. I was retained to review the care received from the point of arrival and determine whether the ER personnel acted within the standard of care in assessing and caring for this patient in an appropriate and timely manner.

Testicular Torsion

Two days after undergoing a vasectomy, an adult male presents to the ER with scrotal pain and swelling. He was evaluated and discharged. Several days later he was admitted for emergency surgery and lost his testicle. I was retained to review the care he received on his first visit with regard to standard of care and potentially failure to diagnose.

Cardiac Arrest in a patient with Congestive Heart Failure

A patient with chronic congestive heart failure presented to an emergency room multiple times over several months, ultimately going into cardiac arrest during one visit. I was retained to evaluate the workup done and the care she received on that final visit.

Fractured vertebrae following a motor vehicle collision

The driver of a car was evaluated following a highway motor vehicle crash. He was discharged with a presumptive diagnosis of muscular back pain, but was ultimately found to have fractures in his spine. I was retained to comment on the standard of care during his initial evaluation and treatment.

Sinusitis and subsequent meningitis

A young adult female developed headaches and subsequently became more and more debilitated until she died from frontal sinusitis and suppurative meningitis. I was retained to examine accusations of failure to diagnose and subsequent failure to treat as well as to evaluate whether or not the emergency physician met the standard of care in evaluating and treating this patient.

Gastrointestinal (GI) bleed

An adult male was admitted for GI bleed and had subsequent evaluation and treatment. He was discharged home and returned several days later by ambulance in cardiac arrest. The issue to be determined was whether the emergency physician met the standard of care in diagnosis and treatment, and whether or not the discharge was safe and appropriate.

Hand trauma with retained foreign body (FB)

A hand injury sustained from broken glass was evaluated and repaired. One to two weeks later it began to bleed and nerve deficit was noted. A small retained foreign body was discovered in surgery. Issue: Did the ER initial evaluation and treatment fall below the standard of care?

Shoulder injury

A mountain biking crash resulted in a fracture-dislocation of an adult male’s shoulder. It was reduced in the ER and there was subsequent nerve damage and prolonged recovery with complex surgery required. Issue: Did the ER practice at or below the standard of care?