A 47-year-old man with no history of migraine comes to his longtime nurse practitioner with a new pulsating headache, nausea, and light sensitivity, and nothing on the exam looks alarming. Over the next two months the NP escalates his care at every step, with an MRI, two neurology referrals, and an ER visit, until he’s finally diagnosed with a rare, devastating encephalitis. In this episode of Scrubs and Subpoenas, Dr. Wendy Wright and Dr. Sally Miller look at how a case that met the standard of care still ended in a $2 million settlement, and why the malpractice carrier, not the NP, made that call. They also share practical ways to protect yourself and your patients, including documenting ED recommendations, using the Z code for treatment refusal, and pushing back when referrals don’t give you answers.

An imperfect suicide risk assessment can end in disaster, and this episode dives into the grave effects of misdiagnosis in psychiatric care. We take a roller coaster journey through a young adult's intense psychotic episode, subsequent gaps in diagnosis and care, and a tragic end. Dr. Sally Miller and Wendy Wright discuss the crucial implications of stepping outside clinical scope, misuse of clinical terms in documentation, and language barriers in mental health assessment. Learn how to close these gaps before they cost a life, and how to protect yourself when they do.

YouTube: https://youtu.be/MBgVb6M6T2k?si=HAYYtYWiLYCwuayh

Scrubs & Subpoenas is back! Host Dr. Sally Miller and Fitzgerald faculty member Wendy Wright break down a pediatric misdiagnosis that became a malpractice case: a 10-year-old boy with persistent abdominal and neck pain, normal diagnostic workups, and a final finding of papilledema. Learn how to protect your patient when the tests come back clean but the symptoms continue, and how to protect yourself from litigation when they do.

YouTube: https://youtu.be/sDBD2hTOoF4?si=9ITAaPyuw9v_O8Qy

On the season finale of Scrubs & Subpoenas, we explore a case between a gynecological NP and a patient diagnosed with breast cancer. Who is at fault when a patient declines to speak about a sensitive subject? Is diagnosis possible when a patient refuses care besides treatment of acute conditions? We explore these hypotheticals and more during this episode highlighting the importance of women's cancer screenings, well-woman's visits, and family history disclosure.
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YouTube: https://www.youtube.com/watch?v=DomZ0GO959c&list=PLf0PFEPBXfq7ulhFgs9CqJeed6m4gEq1w

The aging process is wildly unpredictable. A person’s health can go from pristine to poor in a matter of months, no matter the quality of medical care they receive. In this episode, we explore the complicated timeline of a woman who resided in multiple elder care homes before dying due to chronic infection. Learn about this sweeping lawsuit forged against multiple medical entities, and the importance of meticulous documentation and time-sensitive interventions.
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YouTube: https://www.youtube.com/watch?v=_0zN4vz4YYU&list=PLf0PFEPBXfq7ulhFgs9CqJeed6m4gEq1w

What started as a complaint of hand pain in an elderly patient turned into a full fledged malpractice suit against an NP. In this episode, we examine how ordering the “wrong” test can land a provider in hot water—even if it does not directly lead to a patient’s death. Hear expert witness Sally K. Miller weigh in on whether wrongdoing was really committed, or if this is another case of excessive legal force used in the medical field.
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YouTube: https://www.youtube.com/watch?v=XnB4wQigN8s&list=PLf0PFEPBXfq7ulhFgs9CqJeed6m4gEq1w

In a psychiatric emergency, every decision is crucial. In this sad case, a patient in metal health crisis lost his life under the care of a medical team—leading to a charge against the attending NP on the scene. We explore this rare instance in which following protocol to a tee isn’t realistic or safe, and how providers must walk a fine line between acting from instinct and following the rules. Listen in for our hosts’ expert takes on what could be done differently in these cases, and where fault truly lies.
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YouTube: https://www.youtube.com/watch?v=vMd0M3YIbgg&list=PLf0PFEPBXfq7ulhFgs9CqJeed6m4gEq1w

This week’s case is a terrifying reminder that an NP can do everything right and things still may go wrong. Dr. Sally K. Miller recounts a story centered around a patient with a persistent and mysterious skin lesion. After a dizzying amount of appointments, referrals, biopsies, and inconclusive examinations spanning years, this case simply slipped through the cracks and ended in disaster. Here, listeners learn what should have been done differently and who truly is at fault in complex healthcare scenarios.
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YouTube: https://www.youtube.com/watch?v=_Qg7G7g2v8I&list=PLf0PFEPBXfq7ulhFgs9CqJeed6m4gEq1w