Healthcare News & Insights

Medical advice calls: Should they be allowed in ERs?

Emergency rooms (ERs) are often very busy places, handling life and death situations. So what happens when someone calls the ER and asks for medical advice? Should your providers take the call and give the advice?

If you want to play it safe and protect your facility, the answer’s no.

In fact, according to a recent case law update published in the Journal of Healthcare Risk Management, in the majority of cases it’s inappropriate for providers to give advice over the phone to people they’ve never seen or examined.

If it’s a patient calling to get his or her discharge orders clarified, that’s a different story. But providers still need to be careful about how they handle these conversations.

Medical malpractice case

The case that brought this topic up for review was Estate of Kundert v. Illinois Valley Community Hospital.

On May 31, 2007, Kameryn Kundert, who was born April 18, 2007, was fussy, and he wasn’t eating or sleeping. His mother, Krista, tried to reach the infant’s pediatrician, but when she couldn’t, she called Illinois Valley Community Hospital and asked to speak to a “medical professional.”

She was transferred to the emergency department (ED) and explained the baby’s condition to the person who took the call — whose identity remains unknown. The “medical professional” told her she was overreacting, and that the baby would be fine. She was to give him Tylenol and follow up the next morning with her pediatrician.

The person also added that while Kameryn didn’t need immediate medical attention, even if he did, the facility wasn’t equipped to take care of ill infants.

First thing the next day, Krista took Kameryn to see his pediatrician. After the doctor examined the child, he arranged for an ambulance to take the child to Illinois Valley and called the facility to let them know a septic 6-week-old infant was on his way.

Upon arrival to the hospital, the baby had a lumbar puncture and chest X-ray, and was administered fluids and oxygen. Kameryn was later transported to a facility that was equipped to care for critically ill infants.

On June 15, 2007, Kameryn died.

Verdict

His parents brought a a suit for medical negligence against Illinois Vally Community Hospital, saying the person who told Krista not to seek immediate medical attention was negligent. The hospital filed a motion to dismiss the lawsuit saying it had no duty to Kameryn or his parents because “it had not entered into a provider/patient relationship with them.”

After the trial court granted the motion to dismiss, the case was appealed.

The appeals court also found there was “no duty between the hospital and Kameryn; hence, there could be no liability for the advice given by the unknown person in the ED.”

The court affirmed the dismissal of the case.

Play it safe

In this case, the hospital won. But why take the chance?

The best policy to have for your ED is to tell all callers to “hang up and call 911, drive the person to an emergency room or contact a provider of their choice.”

Reason: It’s inappropriate for providers to give advice over the phone when they’ve never seen or examined the person. In addition, providers can’t tell via the phone if the patient is accurately describing the person’s condition and they might misinterpret the information.

The only time your providers should answer a question is if it is a specific answer, such as,  “What is the number for poison control?”

This policy should be put in writing and include specifics on who will handle public inquiries for medical information and how these calls will be documented. By doing this, all ED personnel will know how to handle these calls safely.

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