Bedside Ultrasound and Being Sued
A Review of Lawsuits Related to Point-of-Care Emergency Ultrasound Applications. Stolz L, O’Brien K, Miller M, et al. Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health, 16 (1) 2015.
Point of care ultrasound is being used with increasing frequency in the emergency medicine. New medical technologies carry medico-legal risk. This study aims to review reported legal decisions related to ultrasound in emergency medicine.
Investigators conducted a retrospective review of cases in the Westlaw Database (Repository of state and federal case law) from 2008-2012. Cases were included in which there was an emergency physician named, there was a failure to perform or delay in performing ultrasound, or misinterpretation of an ultrasound. The ultrasound study was one of the ACEP core applications (i.e. DVT, RUQ, etc.).
Only five cases were identified. All five cases were either a failure to perform, or delay in obtaining ultrasound. There were no cases in which the physician misinterpreted the study.
Based on this study, it seems as though you are more likely to be sued if you delay or fail to perform a point of care ultrasound when it is indicated. However, this study was limited in many ways, not the least of which is this: no settled cases or sealed cases are available in the Westlaw database. When there is real negligence (i.e. failing to catch a 10 cm AAA on US), the case rarely goes to trial. Perhaps there are many cases of misinterpretation that this study could not identify. Regardless, as point of care ultrasound becomes more and more ubiquitous, we will be expected to perform them when indicated and to interpret them accurately, and we will be held accountable when we fail to do so.