Abstract
Background
Previous investigators have assessed United States Case Law to evaluate the medicolegal
risk surrounding point-of-care ultrasound applications. These studies have suggested
that nonperformance is the primary source of an allegation of medical malpractice.
Objectives
The objective of this study is to update the literature regarding medical malpractice
cases involving ultrasound applications that could be used at the point of care, and
assess the risk conveyed to advanced practice providers and by application of emerging
applications of ultrasound.
Methods
Authors reviewed the Westlaw database for medical malpractice cases involving point-of-care
ultrasound applications between December 2012 and January 2021. Cases were included
if there was an allegation of misconduct by an emergency provider and if an ultrasound
included in the American College of Emergency Physicians investigators core, extended,
emerging, or adjunct applications was discussed to any degree. Investigators independently
reviewed the cases for inclusion. Authors abstracted the case information, type of
ultrasound performed, and the specific allegation of misconduct.
Results
Nineteen cases met inclusion criteria. Seven cases involved core applications of emergency
ultrasound and 13 involved extended, emerging, or adjunct applications. One case was
included in both categories as it included elements of both core and extended applications.
The most common primary allegation was failure to perform an ultrasound. No cases
clearly alleged misinterpretation of a point-of-care ultrasound.
Conclusion
As previous studies have suggested, nonperformance of ultrasound seems to convey the
greatest medicolegal risk. Extended, emerging, or adjunct applications of ultrasound
may convey a slightly higher risk.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
REFERENCES
- Trends in diagnostic point-of-care ultrasonography reimbursement for Medicare beneficiaries among the US emergency medicine workforce, 2012 to 2016.Ann Emerg Med. 2020; 76: 609-614
- Advanced practice provider point-of-care ultrasound guidelines.Ann Emerg Med. 2019; 74: e89-e90
- Emergency department and urgent care medical malpractice claims 2001–15.West J Emerg Med. 2021; 22: 333-338
- Provider and practice factors associated with emergency physicians being named in a malpractice claim.Ann Emerg Med. 2018; 71 (e4): 157-164
- Analysis of lawsuits filed against emergency physicians for point-of-care emergency ultrasound examination performance and interpretation over a 20-year period.Am J Emerg Med. 2012; 30: 338-341
- A review of lawsuits related to point-of-care emergency ultrasound applications.West J Emerg Med. 2015; 16: 1-4
- Emergency ultrasound imaging criteria compendium.Ann Emerg Med. 2016; 68: e11-e48
- Ultrasound guidelines: emergency, point-of-care and clinical ultrasound guidelines in medicine.Ann Emerg Med. 2017; 69: e27-e54
- Association between US physician malpractice claims rates and hospital admission rates among patients with lower-risk syncope.JAMA Netw Open. 2020; 3e2025860
- An epidemiologic study of closed emergency department malpractice claims in a national database of physician malpractice insurers.Acad Emerg Med. 2010; 17: 553-560
- Malpractice claim fears and the costs of treating Medicare patients: a new approach to estimating the costs of defensive medicine.Health Serv Res. 2018; 53: 1498-1516
- A systematic review of the cost-effectiveness of ultrasound in emergency care settings.Ultrasound J. 2021; 13: 16
- Point-of-care ultrasonography (POCUS) in a community emergency department: an analysis of decision making and cost savings associated with POCUS.J Ultrasound Med. 2019; 38: 2133-2140
- Impact of point-of-care ultrasound on disposition time of patients presenting with lower extremity deep vein thrombosis, done by emergency physicians.Turk J Emerg Med. 2017; 18: 20-24
- Impact of point-of-care ultrasonography on ED time to disposition for patients with nontraumatic shock.Am J Emerg Med. 2016; 34: 1022-1030
- Role of point-of-care ultrasound study in early disposition of patients with undifferentiated acute dyspnea in emergency department: a multi-center prospective study.J Ultrasound. 2021 May 29; ([Epub ahead of print])https://doi.org/10.1007/s40477-021-00582-y
- Real-time B-mode ultrasound in the ED saves time in the diagnosis of deep vein thrombosis (DVT).Am J Emerg Med. 2004; 22: 197-200
- Does the use of bedside pelvic ultrasound decrease length of stay in the emergency department?.Pediatr Emerg Care. 2013; 29: 67-70
- Effect of emergency physician-performed point-of-care ultrasound and radiology department-performed ultrasound examinations on the emergency department length of stay among pregnant women at less than 20 weeks' gestation.J Ultrasound Med. 2018; 37: 2497-2505
Article info
Publication history
Published online: May 05, 2022
Accepted:
April 23,
2022
Received in revised form:
March 22,
2022
Received:
January 9,
2022
Footnotes
Meetings: Department of Emergency Medicine Research Day – June 2021, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Identification
Copyright
© 2022 Published by Elsevier Inc.
