Rhabdomyolysis in a Previously Healthy 33-Year-Old Man

Rhabdomyolysis in a Previously Healthy 33-Year-Old Man

Urgent message: Life-threatening degrees of rhabdomyolysis can be seen in young, healthy patients with stable presentation and nearly normal examination findings.   John Shufeldt, MD, JD, MBA, FACEP and Zana Alattar, MS3   Introduction This case demonstrates the importance of considering and ruling out rhabdomyolysis in patients with myalgia. We describe a case illustrating the management and work-up of myalgia in a young, healthy individual to identify the underlying cause. As with many illnesses, the …

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Head Injuries and Cirrhosis: Does everyone need a CT Scan?

Head Injuries and Cirrhosis: Does everyone need a CT Scan?

Urgent message: The decision of whether or not to image a patient with a head injury has significant implications—for the patient and the urgent care provider. Understanding which patients are at greatest risk for serious head injury, indications for testing, and options for management/disposition is essential. Brandon Godfrey, MD; Haylie Wiesner, BS; and John Shufeldt, MD, JD, MBA, FACEP Case A 47-year-old male with a history of alcohol abuse and cirrhosis presents to an urgent …

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Boerhaave Syndrome in a 41-Year-Old Female

Boerhaave Syndrome in a 41-Year-Old Female

Urgent message: While Boerhaave syndrome is a rare finding, a relatively high number of cases may present in the urgent care setting. As such, awareness of and vigilance for related symptoms are essential to taking a proper history and, ultimately, early diagnosis of acute, subacute, or chronic Boerhaave syndrome. John Shufeldt, MD, MBA, JD, FACEP, Amber Hawkins, and Carli Nichta, MS4   Introduction Boerhaave syndrome is a spontaneous esophageal rupture indicated in some cases by …

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Acute Compartment Syndrome—An Urgent Care Review

Acute Compartment Syndrome—An Urgent Care Review

Urgent message: Acute compartment syndrome (ACS) is an important high-risk diagnosis to exclude when evaluating peripheral extremity injury. Providers must maintain a high clinical index of suspicion with careful attention to the history and mechanics of injury in an urgent care setting to preclude the devastating, rapidly developing sequela of ACS. Missing a case of ACS may result in significant morbidity—and even mortality. Awareness of both subtle and overt signs will ensure the best care …

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Two-Thirds

JOHN SHUFELDT, MD, JD, MBA, FACEP Editor’s note: For almost 10 years, Dr. John Shufeldt has generously shared his talents as a writer, legal expert, and thought leader with JUCM readers as the contributing editor of our Health Law department. Although John is retiring as its regular contributor, he will always remain its award-winning founder. In future issues, the Health Law column will be expanded to include new contributors and cover a broader scope of …

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Medical Malpractice Trial, Part 3: The Trial

JOHN SHUFELDT, MD, JD, MBA, FACEP Recap of the Facts Johnny Dalton presented to the emergency department (ED) at St. Jacob’s Hospital after ingesting liquid methadone, a long-acting opioid. Responsive Emergency Medicine and Dr. Beth Ange evaluated and monitored Johnny for nearly 12 hours and discharged him home. Johnny was found dead by his family approximately 20 hours after discharge. Case name: John and Cathy Dalton v. Dr. Beth Ange and Responsive Emergency Medicine Decedent: …

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Aortic Dissection

Aortic Dissection

Urgent message: Although chest pain in young adults is often benign, it is important to realize that emergency cases can sometimes be disguised as normal examination findings in adults. ZANA ALATTAR and JOHN SHUFELDT, MD, JD, MBA, FACEP This case demonstrates the importance of considering and ruling out rare cases of aortic dissection in patients with chest pain. We describe a case illustrating the approach to the management and work-up of chest pain in young …

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Medical Malpractice Trial, Part 2: Pretrial

JOHN SHUFELDT, MD, JD, MBA, FACEP Johnny Dalton presented to the emergency department (ED) at St. Jacob’s Hospital after ingesting liquid methadone, a long-acting opioid. Responsive Emergency Medicine and Dr. Beth Ange evaluated and monitored Johnny for nearly 12 hours and discharged him home. Johnny was found dead by his family approximately 20 hours after discharge. Case name: John and Cathy Dalton v. Dr. Beth Ange and Responsive Emergency Medicine Decedent: Johnny Trey Dalton Attorney …

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Medical Malpractice Trial, Part 1: The Events

John Shufeldt, MD, JD, MBA, FACEP I recently spent 3 amazing weeks in a medical malpractice trial. Over the next few months, I would like to share the experience with you. Despite the fact that I practice law and have been an expert witness for more than 20 years, the experience opened my eyes and has definitely changed how I practice medicine in the urgent care setting. I took copious notes during the trial and …

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Medical Boards: Part 2

JESSICA HOFFMANN, MS-4, and JOHN SHUFELDT, MD, JD, MBA, FACEP The probability that you will receive a certified letter from your medical board informing you about an investigation is relatively low. But one day, you may be one of the unlucky souls who receives such a letter. What do you do? Different boards have different rules about what gets reviewed or investigated and what does not. Some boards are mandated to investigate, at least to …

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