Immobilize injured extremities freely. Know when to call your consultants. Give complete instructions on care of the injury and always provide a mechanism for follow-up. Develop a QA system to monitor any trends in missed x-rays. Fracture Management Fractures and other orthopedic injuries cause the greatest number of malpractice suits in Emergency Medicine.
Suits resulting from orthopedic injuries have several common causes.
First is failure to suspect fractures and therefore failure to x-ray the affected part. This is most dramatically associated with the intoxicated trauma patient who has an unsuspected vertebral fracture. A second cause is failure to recognize fractures because either fractures could not be seen in the radiographic views obtained, or the fracture was not recognized by the physician. And finally, poor discharge instructions can result in inadequate care of an injury that can potentially result in catastrophic disabilities. The most commonly missed fractures are of extremities.