Trends in Pediatric Malpractice Claims 1987-2015: Results From the Periodic Survey of Fellows.

Background: Pediatricians are less frequently sued than other physicians. When suits are successful, however, the average payout is higher. Little is known about changes in the risk of litigation over time.

Understanding Liability Risks and Protections for Pediatric Providers During Disasters.

Although most health care providers will go through their careers without experiencing a major disaster in their local communities, if one does occur, it can be life and career altering. The American Academy of Pediatrics has been at the forefront of providing education and advocacy on the critical importance of disaster preparedness. From experiences over the past decade, new evidence and analysis have broadened our understanding that the concept of preparedness is also applicable to addressing the unique professional liability risks that can occur when caring for patients and families during a disaster.

Understanding Liability Risks and Protections for Pediatric Providers During Disasters.

Although most health care providers will go through their careers without experiencing a major disaster in their local communities, if one does occur, it can be life and career altering. The American Academy of Pediatrics has been in the forefront of providing education and advocacy on the critical importance of disaster preparedness. From experiences over the past decade, new evidence and analysis have broadened our understanding that the concept of preparedness is also applicable to addressing the unique professional liability risks that can occur when caring for patients and families during a disaster.

A Misdirected Patient Transfer Raises Emergency Medical Treatment and Labor Act Liability Issues.

Children often require transfer to pediatric hospital emergency departments (EDs) after evaluation in community hospital EDs. Such transfers are regulated by the federal Emergency Medical Treatment and Labor Act. Unusual circumstances, such as logistical errors in the physical transfer of the patient, may increase Emergency Medical Treatment and Labor Act-related liability risks for hospitals and ED physicians.

Relative productivity of nurse practitioner and resident physician care models in the pediatric emergency department.

Objectives: Duty hour restrictions limit the use of resident physicians in pediatric emergency departments (PEDs). We sought to determine the relative clinical productivity of PED attending physicians working with residents compared with PED attending physicians working with nurse practitioners (NPs).

Methods: In a tertiary care PED with multiple care models (PED attending physicians with residents and/or fellows, PED attending physicians with NPs, PED attending physicians alone), we identified periods when care was provided concurrently and exclusively by a PED attending physician with 1 to 2 residents (resident pod) and a PED attending physician with 1 NP (NP pod).

Moving on up: is it safe for patients to relocate to higher altitude following the fontan procedure?

The change in clinical status of patients status post-Fontan surgery who relocated from low (<1,500 feet) to moderate (>4,000 feet) altitude was assessed. Cardiology databases were queried for patients meeting inclusion criteria. The clinical records of these patients for the 6 months before and 6 months after relocation were then reviewed.

Challenging assumptions about uninsured children in the pediatric emergency department.

Objective: Emergency departments (EDs) are experiencing increased volumes and crowding problems. Although crowding is often blamed on uninsured patients, the role of uninsured children is unclear. We compared ED use by insured and uninsured children.

Does the emergency medical treatment and labor act affect emergency department use?

Background: Emergency departments (EDs) face increasing patient volumes and economic pressures. These problems have been attributed to the Emergency Medical Treatment and Labor Act (EMTALA).

Study Objective: To determine whether modifying EMTALA might reduce ED use.

When bad things happen: adverse event reporting and disclosure as patient safety and risk management tools in the neonatal intensive care unit.

The Institute of Medicine has recommended a change in culture from "name and blame" to patient safety. This will require system redesign to identify and address errors, establish performance standards, and set safety expectations. This approach, however, is at odds with the present medical malpractice (tort) system.

Should we fear "flu fear" itself? Effects of H1N1 influenza fear on ED use.

Background: Surges in patient volumes compromise emergency departments' (EDs') ability to deliver care, as shown by the recent H1N1 influenza (flu) epidemic. Media reports are important in informing the public about health threats, but the effects of media-induced anxiety on ED volumes are unclear.

Objective: The aim of this study is to examine the effect of widespread public concern about flu on ED use.

Pediatric emergency department use by adults with chronic pediatric disorders.

Objective: To describe pediatric emergency department use by adults with chronic pediatric disorders, known as transition patients.

Design: Retrospective descriptive study.

Setting: The pediatric emergency department of a tertiary care pediatric hospital during calendar year 2005.

The reimbursement gap: providing and paying for pediatric procedural sedation in the emergency department.

A number of medical, ethical, and legal obligations compel physicians to provide procedural sedation and analgesia (PSA) to pediatric patients requiring painful procedures in the emergency department (ED). Recognizing the additional demands that PSA places on ED physicians, the American Medical Association has approved Current Procedural Terminology codes for PSA in conjunction with ED procedures. However, some insurers have indicated reluctance or refusal to pay for PSA in the ED, despite these Current Procedural Terminology codes and the legal and ethical imperatives.

Medical diagnoses commonly associated with pediatric malpractice lawsuits in the United States.

In this article we discuss the medical diagnoses underlying the most common lawsuits involving pediatricians in the United States. Where applicable, specific and general risk-management techniques are noted as a means of increasing patient safety and reducing the risk of medical malpractice exposure.

Narrative review: do state laws make it easier to say "I'm sorry?".

Initiatives intended to reduce the frequency and impact of medical errors generally rely on recognition and disclosure of medical errors. However, fear of malpractice liability is a barrier to physician disclosure. Some U.

Deficits in EMTALA Knowledge Among Pediatric Physicians.

Objective: All US hospitals that participate in Medicare and Medicaid are regulated by the Emergency Medical Treatment and Active Labor Act (EMTALA). The law was enacted to prevent hospitals from turning away patients with emergency medical conditions. The law imposes specific obligations on hospitals and their physicians, and provides severe penalties for violations.

Will EMTALA changes leave emergency patients dying on the hospital doorstep?

Despite charges that it is at times ambiguous and overly burdensome, the Emergency Medical Treatment and Labor Act (EMTALA) remains an important protection for patients, and a valuable instrument for enforcing public policy goals in the area of emergency healthcare services. The 250 Yard Rule is a small but crucial part of EMTALA, extending the statute's protections to emergency patients who have narrowly failed to reach the hospital's entrance. Following recent revisions to EMTALA's implementing regulations, some health-care law practitioners and senior federal regulators have opined that enforcement of the 250 Yard Rule will be dramatically curtailed.