10 Critical Lessons I’ve Learned As An Expert Witness W / Amal Mattu, MD

10 Critical Lessons I’ve Learned As An Expert Witness

Amal Mattu, MD
University of Maryland School of Medicine

1. A good documented history, physical, and medical decision-making is more protective than ordering lots of tests! (and takes less time)
a. If a test is abnormal, you better address it!
b. Ordering lots of tests to CYA is a bad idea!

2. Vital signs are called “vital” for a reason
a. Check VS and fix abnormal VS before dc...or address why they are abnormal
i. Don’t assume you will always be notified when VS are going bad!
b. Pay attention to the MAP and the shock index!

3. If your patient is sick, watch the clock!
a. Every minute counts...every minute will be scrutinized if there is a bad outcome
b. Document the reasons for any delays
c. Don’t assume everything you order is being done STAT!
i. Your staff will not always know when patients need something NOW unless you tell them...and stay on top of them!
d. The lab and the blood bank are not your friends

4. A consult is not a consult if not documented
a. Beware the “phone consults!”
i. Document the conversation clearly
b. Document times of consults

5. Radiology reports: read the fine print

6. Poor communication is a frequent theme in lawsuits
a. Be nice!
b. Communicate test results
c. Communicate expected outcomes
d. Communicate with the family if they are there

7. Assume you (and your staff) are always on camera in the ED
a. Be wary of what you say and what you do at all times

8. Know the major guidelines of your specialty and follow them...or have literature to back you up if you don’t!

9. Before you discharge a patient, look at your chart
a. Does what you documented justify your disposition?
b. Discharge instructions: another chance to get it right

10. Lawsuits will happen...accept it and move on!

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