title: Professional liability in a pediatric emergency department.
abstract: The risk of professional liability resulting from care given in the pediatric emergency department is a growing concern. This retrospective study examined the patients, diagnoses, and outcome of all threatened and actual claims that originated in the emergency department of a pediatric teaching hospital from 1977 through 1988. Twenty-five cases were identified by the hospital risk manager from approximately 320,000 visits (8.0 cases/100,000 visits); 22 charts were available for review. Ages of the patients ranged from 2 weeks to 13 years (mean 2.9 years, median 3.0 years). The patients' payment status was private insurance (n = 10), state public aid (n = 5), and no third-party payment source was listed for 7 children. Ten patients (46%) visited the emergency department between midnight and 8:00 AM, when an attending physician was not present. Return visits within 2 weeks for the same complaint occurred in 10 cases. The majority of the patients were discharged home (n = 18), and all of them had appropriate, adequately documented discharge instructions. The final diagnoses fell into four general categories: minor trauma/abuse (n = 7), neoplasms/chronic illnesses (n = 7), infectious diseases (n = 6), and appendicitis (n = 2). Review of the charts before knowledge of the legal outcome raised quality-of-care issues in 41% of the cases (n = 9).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Pediatrics, Northwestern University, Children's Memorial Hospital, Chicago, Illinois.
authors.forename: S L
authors.initials: SL
authors.lastname: Reynolds
authors.forename: D
authors.initials: D
authors.lastname: Jaffe
authors.forename: W
authors.initials: W
authors.lastname: Glynn
mesh_terms: D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007087:Illinois; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008318:Malpractice / Q000191:economics; D011787:Quality of Health Care; D012189:Retrospective Studies; D012306:Risk