Page 14 - Hospitalists - Risks When You're the Doctor in the House (Part Two)

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

troponin levels. A nurse noted she received the report and
attempted to catch Mr. Forrest in the parking lot, but Mr.

Forrest had already left. She also informed Dr. Robinson
of the test result, but neither Dr. Robinson nor the nurse

made any further attempts to contact Mr. Forrest or advise
him to return to the hospital immediately.

The next day, Mr. Forrest’s family found him gurgling and

breathing abnormally and called an ambulance. Before
it arrived, Mr. Forrest stopped breathing. The ambulance

crew was able to resuscitate him, but he suffered severe
anoxic brain damage which left him in a persistent

vegetative state. A myocardial infarct was confirmed by
a peak creatinine kinase level of 7,420 units/L (reference

range for men is 38 to 174 units/L).

The family sued Dr. Robinson, whose defense was

primarily that the patient had insisted on being discharged
against medical advice. However, the family disagreed

that Mr. Forrest had been advised to remain in the hospital
because of a pending test result. As the medical record

was devoid of any documentation attesting to Dr.
Robinson’s version of events, his defense was severely

compromised.

Whenever possible, patients should not be discharged with

pending test results. This is, however, often impractical in light
of economic pressures to reduce the length of hospital stays.

More and more patients are being discharged with unresolved
medical issues. When this happens, the patient should be

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