Critical Care Malpractice Guide

What a critical care review usually focuses on

Icu monitoring, infection, ventilation, and escalation. A case review should reconstruct the sequence of hemodynamic monitoring, ventilation, infection management, escalation, and multi-organ support from the records available at each decision point.

Five decision points to map

• 1. Hemodynamic monitoring
• 2. Ventilation
• 3. Infection management
• 4. Escalation
• 5. Multi-organ support

Records that can answer those questions

• Critical Care consultation, procedure, or encounter notes
• Orders and test results used to make the clinical decision
• Medication, monitoring, procedure, or nursing records tied to the event
• Communication with the patient and other specialties
• Later treatment showing the complication, corrected diagnosis, or outcome

Expert and causation questions

• What training and specialty should the reviewing critical care expert have under state law?
• Which of the key decision points in icu monitoring, infection, ventilation, and escalation is actually being challenged?
• What information was available at that time, not only in hindsight?
• What part of the later harm is attributable to the underlying illness or known risk?
• Would a different medical decision probably have changed treatment or outcome?

Related specialties