August 4, 2019

A report from Coverys released in June 2019 entitled “Emergency Department Risks: Through the Lens of Liability Claims,” which explored the root causes of medical malpractice claims occurring in the Emergency Department (“ED”) based on an analysis of 1,362 ED-related closed medical professional liability claims at Coverys across the five-year period from 2014 through 2018, stated, “Each year in the United States, there are more than 138 million visits to EDs. Coverys data shows that EDs are the fourth most common healthcare delivery location to trigger a malpractice claim.”

Report Findings

The report found that more than 50% of inpatient hospital admissions begin in the ED and that EDs are the fourth most common healthcare delivery location to trigger a medical malpractice claim, after surgical units, physician offices, and inpatient units.

The report found that the second most common group of allegations in diagnostic-related ED medical malpractice claims are those involving issues related to ordering diagnostic/lab tests. The entire testing continuum, which also includes performance of tests, receipt/transmittal of test results, and interpretation of tests, combine to trigger 44% of all diagnostic-related ED medical malpractice claims, according to the report.

The report found that 44% of the ED medical malpractice cases that were classified as diagnosis-related identified the initial history and physical (H&P) and evaluation of the patient as the stage at which the diagnostic process broke down.

The report found that allegations of issues related to medication management accounted for 9% of ED medical malpractice claims, and the most common medications involved in an ED allegation (49% of all medication-related allegations in the ED) were antibiotics, opioids, and anticoagulants.

The report found that issues pertaining to documentation and electronic health records (EHR) issues accounted for 10% of all ED medical malpractice claims.

The report found that failure or delay in obtaining a specialty consult accounted for 11% of clinical judgment-related ED medical malpractice claims.

Patient Boarding In The ED

Patient boarding is when patients remain in the ED after they have orders to be admitted for inpatient hospitalization. The report stated that many boarded patients in the ED are psychiatric patients waiting for acute psychiatric bed placement. An estimated 50 acute psychiatric beds are needed for every 100,000 people in any given community; however, only 11.7 beds are currently available per 100,000 people. Most other boarded patients are typically those that have been stabilized but are waiting to transfer to an inpatient bed in the facility.

Report Conclusions

Coverys’ claim data showed that 32% of medical malpractice claims in the ED involve permanent injuries and 38% involve grave injury or death. The report concluded: “In the coming year, hospital emergency departments in the U.S. will receive more than 138 million patient visits. This high volume of patients comes with distinct risks. Coverys claims data shows that EDs are the fourth most common healthcare delivery location to trigger medical professional liability claims. On a national scale, 52% of emergency medicine physicians will be sued, 26% of them more than once. And the burden of that risk rests not just with emergency medicine physicians, but with all who practice in the ED. Of the healthcare providers implicated in ED malpractice claims, 33% are not emergency medicine physicians, but rather general medicine physicians, radiologists, surgeons, other specialists, and advanced practice providers. In the ED, we succeed and we fail as teams — teams whose members must, in working together, provide expertise and care that eclipses the impact that one provider alone could deliver.”


If you or a loved one suffered serious harm as a result of emergency department malpractice in the United States, you should promptly find a medical malpractice lawyer in your state who may investigate your emergency department medical malpractice claim for you and represent you or your loved one in an emergency room medical malpractice case, if appropriate.

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