Anyone who has been in an emergency room may be familiar with the frustration of not getting to see a doctor fast enough. A prospective patient may be in the worst pain in their life or feel like they are having a heart attack and have to wait in line before the ER staff will even ask about what’s happening.
Delays in treatment can have a devastating impact on your health. Treatment delays can involve minutes that can worsen the damage from a stroke to delays in weeks or months that allow a small cancer to grow and spread, which could make the cancer untreatable. An unreasonable delay in medical care can be a basis for a medical malpractice claim.
If your doctor failed to provide proper care or the hospital ignored your complaints, causing serious injury and harm, you may be able to recover money for your losses. If you want to know if you can sue for medical malpractice after you didn’t receive care fast enough, contact Gilman & Bedigian today online or by phone at 800-529-6162.
Emergency Room Triage
Triage is the medical process for prioritizing multiple patients who need medical care. Triage comes from a French word meaning to sort or select. Hospital emergency rooms use triage to sort patients based on the severity of their condition, with the most serious medical cases moving to the front of the line.
If you come to the emergency room with a minor or severe injury and there are no other patients waiting, you will generally receive immediate treatment. If there are other patients who need care, the hospital will review signs, symptoms, and conditions and you may be placed behind patients with more severe conditions. This can make the ER waiting times extend to multiple hours for mild or moderate injuries
Different medical departments can use different triage systems, including number ratings from 1 to 5 or based on color rankings from white to black. There may also be different triage systems and priorities for children and infants. For example, a common emergency triage system is the five-level triage scale of the emergency severity index (ESI):
- Resuscitation
- Emergent
- Urgent
- Less urgent
- Non-urgent
Under the emergency severity index, hospital officials can quickly evaluate patients based on the stability of vital functions, acuity, immediate life or organ threat, and high-risk presentation. Patients who are considered to be “stable” can be sent to urgent care (UC) or fast-track and may not need to be seen in the main emergency department (ED).
When an emergency room nurse or doctor triages an incoming patient, they may go through a decision tree to determine how to classify the patient’s care. The first step may be determining if the patient requires immediate life-saving intervention, which can include:
- Blocked airway
- Not breathing
- Lack of pulse
- Concerning heart rate or rhythm
- Loss of blood volume
- Immediate need for life-saving medication
- Mental status change
- Unresponsiveness
- Low-oxygenation
If the patient is dying, they are categorized as ESI level 1 for immediate treatment. If not, the nurse may determine whether the patient should wait to be seen. If there is an immediate need to see the patient, they may be put into ESI level 2. Questions to help the medical professional determine who should be seen immediately include:
- Is there a high-risk situation?
- Is the patient confused, lethargic, or disoriented?
- Is the patient in severe pain or distress?
For patients at ESI levels 3,4, and 5, the treatment may depend on the resources available in the hospital or ED at that time. Generally, this depends on how many hospital resources are required. If the patient does not require any hospital resources, they may be ESI level 5. If the patient requires one hospital resource, they can be categorized as ESI level 4. Requiring 2 or more hospital resources can put the patient into ESI level 3. Hospital resources can include:
- X-rays
- MRIs
- Electrocardiograms
- Nebulizer medication
- Laceration treatment
- Lab tests
For comparison, the UPMC Western Maryland Emergency Department can use a color-coded triage system.
- White: No illness or injury.
- Green: Injury or illness but symptoms are less serious and not life-threatening.
- Yellow: Patients present with several symptoms of a significant illness and need immediate attention.
- Red: Patients at this level have a life-threatening injury and require immediate transport to a hospital room for medical intervention.
- Black: The patient has already died or has a mortal injury that will cause death.
HopScore Electronic Triage in Baltimore
Some medical centers are evaluating more evidence-based triage decisions, including Johns Hopkins Medicine in Maryland. “HopScore uses machine-learning methods to predict the risk of critical outcomes and inpatient admission to direct safe and optimal emergency care.”
The HopScore interface uses basic information to determine the risk for critical outcome and risk for hospital admission. Information used to come up with the score include a decision tree based on the complaint and patient information, including:
- Primary chief complaint
- Age and gender
- Vital signs
- Medical history
After the doctor or nurse enters in basic information and responds to specific decision tree questions, the electronic triage (e-triage) will provide a triage score. However, the doctor or nurse can still override the triage score and provide a reason for the override.
Why Do Ambulance Patients Move to the Front of the Line?
In some cases, patients who arrive at the emergency room by ambulance are seen earlier than patients who walk in. There may be a couple of reasons why ambulance patients can get into the ER earlier than other patients. In most cases, the patients arriving by ambulance have already been evaluated by medical professionals before they get to the hospital so the hospital knows what to expect and how to triage the patient.
Depending on the state and area of treatment, when you call 9-1-1 for a medical emergency, the fire department or ambulance is dispatched. Any medical treatment that you receive “in the field” is known as pre-hospital care. This generally involves a paramedic who performs an initial assessment. Paramedics have a limited scope of practice, which can include administering medication, artificial resuscitation, and intubation.
For patients with non-life-threatening medical conditions, the paramedics or fire department may just send the patient to the emergency room with the emergency medical technicians with a fire department or private ambulance service. Before the patient goes to the hospital, the ambulance dispatch generally contacts local EDs to let them know a patient is coming in. If a hospital ED is at high capacity, the ambulance can be directed to another hospital.
When the ambulance contacts an ED, they generally provide initial intake information, which can include the status of the patient and whether the ambulance is bringing in a stable patient or there is a life-threatening medical situation that will arrive. For the most serious medical emergencies, the emergency room team may have already prepped and prepared for the patient and begin treatment immediately upon arrival.
Can I Say I Have Chest Pain to Get In Early?
Emergency medical treatment that may result in immediate admission to the ED can include reports of chest pain, shortness of breath, or symptoms of a stroke. Chest pain and shortness of breath can indicate a heart attack and immediate treatment for heart issues can reduce the chance of serious injury or death. Similarly, stroke treatment in the earliest minutes after can greatly improve outcomes.
In general, you should not claim to have medical symptoms that you do not have. It may get you into the ER more quickly but it can have a negative impact on your health. Giving the doctor false symptoms could result in a misdiagnosis or delayed diagnosis. False medical complaints can also result in unnecessary medical treatment that could cause unnecessary risks of injury.
At the same time, do not downplay any serious symptoms. Many patients downplay the scale of their pain or discomfort because they don’t want to seem like they are exaggerating their pain, be called a hypochondriac, or want to appear tough. Tell the doctor or nurse all your symptoms and be honest about pain levels and discomfort, including:
- Difficulty breathing
- Fainting or loss of consciousness
- Chest pain
- Weakness or numbness
- Abdominal pain
- Fever
- Confusion
- Blood in the urine or stool
- Changes in vision or ability to speak
Is Delayed Medical Treatment Considered Medical Malpractice?
Medical malpractice involves a doctor who deviates from the standards of medical care that causes injury and harm to a patient. Delayed medical treatment can be considered a deviation from the standard of care. If delayed treatment causes injury, harm, or death to a patient, the doctor may have committed medical malpractice.
Delayed treatment can be medical malpractice when the delay was unreasonable under the circumstances. This can depend on a number of factors, including what a reasonable emergency room doctor would have done. To understand what is reasonable or unreasonable or what deviates from the standard of care, an expert witness is generally used to provide important information about the standards of treatment to the judge and jury.
A medical expert in a malpractice case is generally a doctor that works or teaches medicine in the same medical field. For example, if your emergency medicine doctor triaged you and put you into the wrong triage category, causing injury from treatment delays, another ED doctor could review the medical information and find that what your doctor did was a deviation from the standards of medical care.
How Much Is My Delayed Care Injury Worth?
The losses caused by medical malpractice injuries are known as damages in a malpractice claim. Damages can include any economic and non-economic losses associated with the injuries. The amount of damages you can be awarded in a medical malpractice claim often depends on the extent of the harm and damage.
For example, if delayed treatment required additional medical tests and an additional week in the hospital, but the patient fully recovered after, damages may be limited to:
- Loss of wages
- Medical bills
- Pain and suffering
For permanent injuries, disfigurement, loss of a limb, chronic pain, or fatal injuries, the damages can be much more extensive. With permanent injuries, the patient may have to deal with their medical injuries for life and require additional medical care into the future. Permanent injuries may prevent returning to the workforce or earning an income in the future. Disfiguring injuries can limit mobility or cause chronic pain. Damages for serious injuries can include:
- Medical bills
- Future medical care
- Lost wages
- Loss of earning potential
- Pain and suffering
- Emotional distress
- Disfigurement
- Loss of enjoyment of life
If a medical accident causes death from delayed treatment, the estate or family members can recover damages in the place of their loved one by filing a wrongful death lawsuit. A wrongful death lawsuit can help the family get compensation for:
- Medical expenses
- Funeral expenses and burial costs
- Loss of financial support and benefits
- Loss of services
- Loss of parental guidance
How Can I Find Out If I Have a Medical Malpractice Case After an ER Injury?
Many patients who have suffered unnecessary medical injuries because of delayed treatment never file a malpractice claim. Patients may feel like the ER is off-limits to a malpractice lawsuit just because the emergency department was busy. However, doctors are still trained and experienced to provide proper evaluations for incoming emergency patients. This includes proper medical triage to make sure patients get the care they need to avoid further injury or damage.
Filing a medical malpractice lawsuit can do more than just compensate you for your losses. When a doctor, nurse, hospital, or ER makes a mistake, they should be held accountable. Filing a malpractice claim can help improve patient care over the long-term and prompt medical professionals to make changes to make sure these types of accidents don’t continue.
If you want to know if you have a malpractice claim after you didn’t receive care fast enough, you can talk to an experienced medical malpractice attorney. Contact experienced medical malpractice trial attorneys Gilman & Bedigian online or at 800-529-6162 for a free consultation.