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Wash. Court of Appeals published opinion — 845926.pdf

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Wash. Court of Appeals published opinion — 845926.pdf
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what was happening in the context of that [request] is that the sinus
patients were being diverted from me and directed towards my male
colleagues. And very logically, when my schedule is booked out with non-
surgical and medical otolaryngology, it seems only appropriate that for
patient access they go to the next available . . . I also had direct referrals
that were sent to me that were then redirected to Dr. Humphreys.

On November 18, 2018, Dr. Davis asked Dr. Litvack to present an epistaxis case

from the week before at the November Quality Improvement (QI) meeting. 4 Dr. Litvack

responded:

Good idea . . . Briefly, he’s a 59 yo man with epistaxis, chronic
anticoagulation on xarelto for chronic DVTs. Presented as a new clinic
patient on 11/09/18 for removal of rhino rockets after two failed rhino
rockets at local ED. At presentation, he had been bleeding on and off
since 4 am and had passed out 3x in last 3 days. Attempted to manage
epistaxis in out patient unsuccessfully. Packed nose bilaterally and sent
to local ED.

Opportunity to discuss:

-Triage skill sets & types of clinical resources needed to see an ENT
patient in a stand alone clinic.

Dr. Davis forwarded her response to Dr. Humphreys stating, “it does not appear she felt

that her medical decision making is part of the QI issue nor sending the patient away to

a non-UW ED.” The QI meeting took place on November 21, 2018. Dr. Litvack testified

4 Epistaxis is a nosebleed. MERRIAM-WEBSTER.COM DICTIONARY, https://www.merriam-

webster.com/dictionary/epistaxis (last visited Apr. 22, 2024). The goal of QI meetings is not punitive but
to improve patient care and processes to achieve better outcomes. Every faculty member has had cases
presented at QI meetings for various reasons.