> I was under the mistaken belief that they were not the
> responsibility of the A&E consultants. I was mistaken and the
> message is that while they are under your roof the
> resonsiblity is yours.
>
This being an international list and all... I'm not aware of any statute or
case law to clarify the situation in the UK. I suppose it could come down to
individual hospital policy (and I wouldn't put it past a hospital to decide
that these patients are your responsibility without informing you). However,
certainly the hospital has a legal duty to these patients (and I don't
imagine the legal department wanting to spend too much time on arguing how
blame should be apportioned between departments) and ultimately I'd argue
that a shift in resources towards the ED (on the basis of direct consultant
involvement in critically ill patients whether accepted or not) is a cost
effective way of improving the care of accepted patients. Rather than argue
it's not your job, argue that it is your job and you need adequate resources
to do it.
In the US, the legal situation is rather different: EDs have a legal
responsibility (under the Emergency Medical Treatment and Active Labor Act)
to carry out Medical Screening Examinations on patients in the department
even if accepted by other specialities- exact extent of MSE not defined, but
in a case like this, res ipse loquitur argument would suggest that the MSE
was inadequate unless there was good documentation (and the 'check
physiological parameters, call consultant for abnormal physiology' seems
reasonable here).
Matt Dunn
Warwick
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