Syracuse Medical Malpractice and Personal Injury Lawyer Blog
Emergency physicians often focus on the condition that brings a patient to the hospital, but abnormal laboratory findings discovered during that evaluation cannot always be ignored. When test results suggest the presence of a potentially serious disease, the emergency physician may have a duty to recognize their significance, communicate those findings to the patient, and recommend appropriate follow-up care. A recent New York medical malpractice decision examined the duty an emergency physician has to respond to abnormal laboratory results. If you believe an emergency room doctor’s failure to diagnose or communicate a dangerous medical condition caused serious harm, you should speak with an experienced Syracuse medical malpractice attorney.
Factual and Procedural History
Allegedly, the decedent sought treatment in a hospital emergency department after experiencing abnormal vaginal bleeding for approximately two weeks. During the evaluation, the emergency physician ordered laboratory testing that revealed a blood glucose level of 250 mg/dL, a result identified as abnormally high. After addressing the patient’s gynecological complaints, the physician discharged her with instructions to follow up with her obstetrician-gynecologist. Although she received copies of her laboratory results, the discharge instructions focused on her bleeding and did not specifically direct her to obtain further evaluation for her elevated glucose level.
It is reported that approximately six weeks later, the patient developed diabetic ketoacidosis and died. Her estate subsequently filed a medical malpractice action alleging that the emergency physician failed to recognize the significance of the abnormal glucose finding, failed to adequately advise the patient regarding its potential implications, and failed to recommend prompt follow-up with an appropriate physician for further testing and treatment. The emergency physician moved for summary judgment seeking dismissal of the claims.
Reportedly, the emergency physician supported the motion with expert testimony asserting that his treatment complied with accepted emergency medicine practice. The defense expert maintained that the patient’s elevated glucose level was merely an incidental finding discovered while evaluating her primary complaint of vaginal bleeding and that the standard of care required only outpatient follow-up rather than additional emergency testing or hospitalization.
It is alleged that the plaintiff opposed the motion with expert opinions asserting that the elevated glucose level represented a significant warning sign requiring clear verbal communication, documentation in the medical record, and an explicit recommendation that the patient promptly follow up with a primary care physician or endocrinologist for further diabetes evaluation.
Duties Imposed on Emergency Room Physicians
The court explained that a defendant seeking summary judgment in a medical malpractice action must establish either that there was no departure from accepted medical practice or that any alleged departure was not a proximate cause of the patient’s injuries. While competing expert opinions alone do not automatically defeat summary judgment, conclusory opinions or opinions resting on disputed factual assumptions are insufficient to eliminate material issues of fact.
Applying those principles, the court concluded that the emergency physician failed to satisfy his initial burden. The defense expert acknowledged that accepted medical practice required informing the patient about the elevated glucose level and recommending appropriate outpatient follow-up. However, the opinion that the physician complied with that standard rested almost entirely on the physician’s testimony regarding his custom and practice rather than on contemporaneous documentation showing that such advice was actually provided.
The emergency department records contained no notation that the elevated glucose level had been discussed with the patient. Likewise, although the patient received a copy of her laboratory results, the discharge instructions directed her only to follow up with her obstetrician-gynecologist. They did not refer to elevated glucose, diabetes, or the need to consult a primary care physician.
The plaintiff also testified that the only follow-up recommendation discussed during discharge concerned the gynecological appointment. Because the defense expert’s opinions depended upon disputed facts rather than documented evidence, the court found that they were insufficient to establish entitlement to judgment as a matter of law.
The court further determined that the plaintiff’s experts independently raised triable issues of fact. The plaintiff’s emergency medicine expert characterized the glucose level of 250 mg/dL as an alarming finding rather than an incidental laboratory abnormality and opined that accepted practice required the physician to document the result, explain its significance, and specifically recommend follow-up with a primary care physician or endocrinologist within one to two weeks.
An endocrinology expert further opined that timely diagnosis and treatment of diabetes likely would have lowered the patient’s blood sugar and prevented the diabetic ketoacidosis that ultimately caused her death. The court therefore denied the emergency physician’s motion to dismiss the medical malpractice claim.
Speak with an Experienced Syracuse Medical Malpractice Attorney
If you or a loved one suffered serious injuries because an emergency physician failed to recognize, communicate, or properly respond to abnormal test results, the experienced Syracuse medical malpractice attorneys at DeFrancisco & Falgiatano Personal Injury Lawyers can evaluate your case and explain your legal options. Contact our office through our online form or call 833-200-2000 today to set up a confidential and free conference.
