Wash. Court of Appeals published opinion — 845926.pdf

Citation: Wash. Court of Appeals published opinion — 845926.pdf
Jurisdiction: Washington (state)
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Original Source: https://www.courts.wa.gov/opinions/pdf/845926.pdf ↗

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There have been several concerning issues that I have been told about by
others, but for this email I want to focus on the discussion at QI
Conference today regarding the epistaxis patient she managed at the
ESC. Today at conference, and also during an after-conference
discussion I had with her and Mark Whipple, she demonstrated a
significant level of poor medical decision making and most concerning a
complete lack of responsibility and ability to ask for help when needed.
She placed blame on the system, specifically referencing the lack of her
having a nurse to help and not having proper supplies to manage the
epistaxis. At no point, even after I asked her what she would do differently
in the future, did she offer any alternative plan. When I suggested to her
that she could have admitted the patient, consulted Hematology, and then
taken the patient to the OR later that day she stared at me and said, “I
guess I could have called our doc-of-the-day”. I replied that she should be
able to manage this patient, and if needed, should keep in mind that
cancelling clinic and taking a patient to the OR is always an option. It
further concerns me that she did not ask for help with this case and only
presented this case at [QI] Conference because I emailed her requesting
that she do so. Her poor decision making at the beginning is very
concerning, specifically deciding to pull the nasal packs in a coagulopathic
patient when she (in her opinion) did not have the proper equipment to
manage that encounter. Finally, her decision to put this patient in an
ambulance and send them to a local non-UW ED to let the community ED
providers and community OTO provider on call manage this patient further
shows a lack of expertise and poor medical decision making.