Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.

Before we begin, a preview of things to come: The “moral” of this article is, simply put: Have a plan. Planning for in-office emergencies is challenging. But a detailed plan of action can save you from a bad legal outcome. Better yet, it can save a patient’s life. Medical Justice is equipped to work with doctors to vet and optimize their emergency plans of action, reducing a doctor’s liability in the event of an emergency. Schedule a free consultation to learn more. 

On to the main attraction.  

Emergencies are to medical offices what rainstorms are to summer – inevitable, but difficult to predict. And emergencies are not seasonal. But they do have their preferred habitats. Pediatric practices address them frequently, with one study suggesting the average pediatric specialist took care of at least one office emergency every month. In a separate study, 62% of family practitioners reported that at least one office patient necessitated immediate hospitalization and emergency treatment.  

Adult primary care offices most commonly address these emergencies: cardiac arrest, asthma complications, seizures, severe allergic reactions (latex gloves are a common trigger), and psychiatric issues. Pediatricians most commonly address respiratory problems, seizures, infections in infants, and dehydration. 

With stats like that, a doctor’s guard should be up. Expect the unexpected. Prepare to render emergency care, regardless of where you live or work.  

Where does that leave your office? Where do you lie on the spectrum of emergency care? 

Your office is an office. It is not a hospital. You are equipped to provide high-quality care. But even the best medical office on the planet struggles to compete with a hospital.  

Here’s what matters: To a patient, you operate a medical facility. In the event of an emergency, they expect you’ll do more than dial 911 and wait it out. Let’s make this real with two cases from the world outside. Each case describes a different doctor and a different medical practice. Both were caught in emergency situations. But the outcomes varied. Dramatically.  

A patient in her 60s presented at her internist’s office for her yearly physical. While in the waiting room, the patient started feeling ill. She approached the receptionist and then collapsed. The receptionist called 911. But the doctor did nothing other than rotate the patient’s body to minimize the risk of aspiration. When EMS arrived, they could not revive the patient. The doctor was ultimately sued. The lawsuit alleged that had the doctor started CPR and used the AED present in his office, it is likely the patient would have lived. 

Yikes. A horrendous outcome for all parties.  

Our next example follows a similar beat, but with one key difference.  

A patient in her 50s was fasting in preparation for a blood glucose draw. While departing the office, the patient complained of lightheadedness. The patient believed the lightheadedness was caused by her fast. She was taken to an exam room and given a cookie and some juice. The patient then collapsed. In this case, the doctor called a “code blue.” The medical assistant dialed 911. After, the doctor began monitoring the patient’s vitals. The patient received oxygen via a face mask. The patient became pulseless and CPR was initiated shortly before the paramedics arrived at the office. The patient could not be resuscitated. Several weeks passed before an attorney requested the office records. No lawsuit was ever filed. 

Two cases with similar patient outcomes, but two different legal outcomes. Can you spot the obvious differences? In the second case, the attorney saw evidence of a practiced team effort to revive the patient. Therefore, despite the bad outcome, there was no case for negligence.  

That is the power of having a plan. And practicing that plan. 

The big takeaway: There are no statutory requirements that address how to respond to a medical emergency in your office. Taken a step further, there are no Standard of Care guidelines for treating a patient who lapses into an emergency care situation. There are, however, many principles that, if followed, decrease the likelihood of a lawsuit. If you follow the best practices described below, you are more likely to end up like the second doctor (no lawsuit) than the first (big lawsuit). Let’s review. 

Emergencies have bad manners. They do not announce themselves. You and your staff must be prepared to act without warning. Failure to have a plan is a plan for failure. 

Start by considering the following issues… 

• How far is your office from a hospital? How far is your office from the closest emergency care facility? 

• How long does it take EMS to respond to a 911 call from your office? 

• Do you treat a substantial number of patients who have health needs or co-morbidities outside of your specialty? If so, what are the most common potential emergencies these patients might experience? 

• Look to your own past. What types of emergencies have occurred in your office? How did you deal with them? What were their outcomes? 

The next step is equipping your office. We’ll dive into this arm of emergency preparation in Part II. Don’t miss it. 

Medical Justice provides free consultations to doctors facing medico-legal obstacles. We have solutions for doctor-patient conflicts, unwarranted demands for refunds, online defamation (patient review mischief), meritless litigation, and a gazillion other issues. We also provide counsel specific to COVID-19. If you are navigating a medico-legal obstacle, visit our booking page to schedule a free consultation – or use the tool shared below.

Learn how Medical Justice can protect you from medico-legal mayhem… 

Jeffrey Segal, MD, JD

Chief Executive Officer and Founder

Dr. Jeffrey Segal, Chief Executive Officer and Founder of Medical Justice, is a board-certified neurosurgeon. Dr. Segal is a Fellow of the American College of Surgeons; the American College of Legal Medicine; and the American Association of Neurological Surgeons. He is also a member of the North American Spine Society. In the process of conceiving, funding, developing, and growing Medical Justice, Dr. Segal has established himself as one of the country’s leading authorities on medical malpractice issues, counterclaims, and internet-based assaults on reputation.

Dr. Segal was a practicing neurosurgeon for approximately ten years, during which time he also played an active role as a participant on various state-sanctioned medical review panels designed to decrease the incidence of meritless medical malpractice cases.

Dr. Segal holds a M.D. from Baylor College of Medicine, where he also completed a neurosurgical residency. Dr. Segal served as a Spinal Surgery Fellow at The University of South Florida Medical School. He is a member of Phi Beta Kappa as well as the AOA Medical Honor Society. Dr. Segal received his B.A. from the University of Texas and graduated with a J.D. from Concord Law School with highest honors.

In 2000, he co-founded and served as CEO of DarPharma, Inc, a biotechnology company in Chapel Hill, NC, focused on the discovery and development of first-of-class pharmaceuticals for neuropsychiatric disorders.

Dr. Segal is also a partner at Byrd Adatto, a national business and health care law firm. Byrd Adatto was selected as a Best Law Firm in the 2021 edition of the “Best Law Firms” list by U.S. News – Best Lawyers. With over 50 combined years of experience in serving doctors, dentists, and other providers, Byrd Adatto has a national pedigree to address most legal issues that arise in the business and practice of medicine.