Page 13 - Hospitalists - Risks When You're the Doctor in the House (Part Two)

SVMIC Hospitalists - Risks When You’re the Doctor in the House

C A S E S T U DY

An example of why this is important is provided by
the case of Mr. Forrest, 41, who presented at 9 a.m. to

an emergency department for evaluation of chest
pain accompanied by diaphoresis and vertigo. He was

examined by an emergency medicine specialist who
determined admission was appropriate. Upon admission,

Dr. Robinson assumed care of Mr. Forrest, and Dr.
Robinson ordered an ECG, chest x-ray, and blood work.

Later that day, the ECG, chest x-ray, and most of the blood
tests came back normal, and the patient requested that he

be discharged. He reported that his chest pain, while still

present, was abating. However, the result of the troponin
test, which had to be performed at another facility, had
not come back, and Mr. Forrest was still hypertensive.

Subsequently, Mr. Forrest was discharged home. Dr.

Robinson’s discharge note indicated that Mr. Forrest was
ambulatory with chest pain of unknown etiology and

hypertension, and that he was being discharged with
instructions to take aspirin for the chest pain and to see

his primary care physician as soon as possible. Although
Dr. Robinson would later testify that he informed Mr.

Forrest that the troponin test result was still pending,
and that Mr. Forrest replied that he wasn’t interested and

wanted to be discharged anyway, this conversation was
not documented in the medical record.

While Mr. Forrest was leaving the hospital, the testing

facility reported the test results indicated elevated

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