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Critical Care Medicine Malpractice

Hospitals have specialized units dedicated to caring only for higher acuity patients. Because they are critically ill, these patients require intensive monitoring and nursing care to maintain balance of the body systems as they progress through this critical period. These include cardiovascular intensive care, neuro intensive care, surgical intensive care, and medical intensive care. Critical care nurses are specially trained to manage these patients, who are often intubated and receiving mechanical ventilation, have invasive central lines, arterial lines, and aggressive monitoring equipment, such as Swan-Ganz catheters for cardiac monitoring, and central venous pressure monitoring to measure fluid volume status. Oversight by an appropriate surgeon or critical care medicine specialist is essential to quality of care and patient outcomes. Any failure on the part of the bedside nurse to identify, document, and notify the critical care team about a change in the patientís condition may delay potentially lifesaving treatment, resulting in disability or death.

Often a patient who is critically ill requires a multi-disciplinary approach and the primary care team must initiate consults with other teams to manage health problems that arise that they are unable to treat adequately. Failure to consult an outside team, such as nephrology, hematology, infectious disease, pulmonology, dermatology, oncology, or cardiology, can result in the patient receiving less than adequate care. Equipment malfunction, such as monitoring systems or ventilator equipment, may result in untimely death. Often, these patients receive a variety of vasoactive drugs to maintain hemodynamic stability, such as vasopressin, epinephrine, and levophed. Other drugs, such as dopamine, dobutamine, milrinone, midazolam, and propofol present opportunities for potential medication errors in this patient care setting. Often these patients have multiple lines for arterial monitoring of blood pressure and venous access. A number of malpractice cases have involved the administration of a drug to a patient via the incorrect line. For example, administering feeding tube solution via an intravenous route rather than a gastrostomy tube will likely result in death.  

 

An expert in critical care medicine is trained to care for critically ill patients admitted to an intensive care unit in a hospital setting. Critical care is a branch of medicine concerned with life support of critically ill patients who require intensive monitoring. They manage complex medical issues such as respiratory failure, shock, sepsis, and trauma.




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