53yo F has S/S of infection, discharged. Later returns w. septic shock/CVA (Case #497)

• Medical Probability: 6 / 10
• Medical Error Summary: The patient presented febrile and tachycardic. Triage documentation specifically noted lower back pain (6/10, cramping) and numbness/tingling of the right leg. However, the ED physician’s note does ...
• Causation Probability: 7 / 10
• Causation Summary: It is more likely than not that delayed recognition and treatment of an infected obstructing ureteral stone contributed to the patient’s progression to septic shock. The initial presentation include...
• Expert Summary: I am well qualified to serve as an expert in this case based on my clinical and operational expertise in sepsis care. I am a board-certified emergency medicine physician and serve as the Emergency Dep...
• Similar Summary: I encounter cases similar to this one frequently in my practice. Given my role as Emergency Department Director of Sepsis Care, I regularly review and manage sepsis cases in the ED, including presenta...

Neuroleptic Malignant Syndrome (Case #576)

• Medical Probability: 8 / 10
• Medical Error Summary: The chief complaint in this case is stiffness after initiation of psychiatric medications. Stiffness following the start of psychotropic medications should always raise concern for medication-related ...
• Causation Probability: 8 / 10
• Causation Summary: The patient’s presentation was concerning for an early medication-related adverse reaction, most notably possible evolving neuroleptic malignant syndrome (NMS), evidenced by stiffness/rigidity, tach...
• Expert Summary: I am a board-certified Emergency Medicine physician and Associate Professor with extensive clinical experience evaluating and managing critically ill emergency department patients, including medicatio...
• Similar Summary: As a full-time Emergency Medicine physician practicing in a tertiary complex academic medical center with a robust toxicology service, our institution frequently serves as a referral center for patien...

13yo left testicular torsion resulting in orchiectomy (Case #589)

• Medical Probability: 3 / 10
• Medical Error Summary: Based on my review of the available records, it is unlikely that a deviation from the Emergency Medicine standard of care occurred during the Day 1 evaluation. Although testicular torsion is an import...
• Causation Probability: 3 / 10
• Causation Summary: It is very unlikely that a medical error resulted in the injury. The initial presentation should prompt a reasonably competent emergency physician to consider testicular torsion in the differential di...
• Expert Summary: I am a board-certified Emergency Medicine physician, Associate Professor of Emergency Medicine, and an ultrasound fellowship-trained, AEMUS-certified emergency physician. I routinely evaluate pediatri...
• Similar Summary: I encounter cases similar to this approximately once every two months in my clinical practice. As an emergency physician, I regularly evaluate pediatric and adolescent males with abdominal, groin, or ...