Dr. Wittenberg Emergency Medicine

Sample Case Descriptions

Central venous catheter causes pericardial effusion and sepsis

A patient presents with chest pain several days after a central port placement for chemotherapy. A portion of the sheath migrates to the heart and causes a pericardial effusion and the patient develops sepsis. I was retained to review the initial ED evaluation and opine on failure to diagnose.

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.

Pediatric Facial Abscess

A young child presented to their pediatrician and later to an ER for a lip infection several times. Ultimately, they were admitted for urgent surgery resulting in cosmetic complications. I was retained to review the chart and comment on standard of care during the first several visits.

Malaria

A patient presented to an ER with fevers and recent travel. There was a delay in diagnosing him with Malaria. I was retained to comment on the evaluation he received, questions of 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.

Finger abscess

A patient presented multiple times to an ER with a soft tissue finger infection that ultimately needed surgical debridement. The infection and subsequent surgery resulted in some loss of function. I was retained to evaluate the ER's evaluation and treatment of this infection as it progressed.

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?