Tuesday, May 28, 2019 • 13:00 - 14:30
Track 3 - Medico-Legal
Track Chair: Dr. Steve Wheeler
Room: 201

Cognitive Errors and Biases in the ED, How to Avoid Being Sued - Dr. Steve Wheeler

Description: This talk will discuss critical thinking in the ER and what are the common cognitive errors and biases that occur. It will discuss why patients launch legal proceedings and what a judge looks for when making a judgement. To avoid a judgement for the plaintiff we will look at how to avoid making cognitive errors and recognize when biases occur. The goal is to avoid making errors that will result in a judge finding liability.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Learn the common cognitive errors and biases that occur in the ER.
  2. Learn to identify when cognitive errors and biases are occurring.
  3. Understand why patients sue and what is required for a case against you to proceed and possibly be successful.


  1. When you are uneasy, stop and ask why, then act on it, never ignore.
  2. Approach every patient interaction as a new encounter and problem, never assume.
  3. Be polite and professional at all times.

Practicing ER physician for 29 years. Former Vancouver Island Health director for Trauma and ER for 8 years. Medical expert for plaintiff and defendant in over 100 cases.

Resident College Complaints: Insights from an Ongoing Mixed Methods Analysis - Dr. Charlotte Crosbie

Description: The CMPA is receiving an increasing number of requests for assistance from resident physicians named in College complaints. This presentation will highlight the trends in the CMPA’s data concerning resident College complaints and the ongoing research efforts to understand the resident College complaint experience.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Describe the temporal trends in resident College complaints at the CMPA.
  2. Better understand the nature of College complaints against resident physicians.
  3. List three underlying themes for why residents are named in College complaints.


  1. CMPA data shows that College complaints are rising for all physicians and residents are not excluded from this.
  2. There are multiple possible outcomes for a College complaint, but the majority of complaints against residents are dismissed.
  3. Good communication skills and professional behaviour may help reduce your chances of experiencing a College complaint.

Originally from the east coast, Charlotte Crosbie is a PGY-3 Royal College emergency medicine resident at UBC, Vancouver. Prior to her medical training, she studied at the Schulich School of Law in Halifax and obtained her license to practice law. She maintains a keen interest in legal issues as they relate to medical practice, and will be continuing her work regarding resident College complaints with the CMPA next year for her area of enhanced competency.

Expert Nursing Opinion: A Window Into Emergency Care - Ms. Sondra Rutman

Description: In my role as a legal nurse consultant, I have found that bad patient outcomes happen not because of errors committed by a single medical professional, but by the confluence of small mistakes made by several health care workers. Vignettes will illustrate some lessons that can be learned.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Recognize the sum effect of individual errors on patient care.
  2. Acknowledge the impact of professional interpersonal issues on patient care.
  3. Understand that thorough documentation can save your patient (and you!).


  1. Error + error + … + error = disaster.
  2. As your mother taught you, mind your manners.
  3. Document, document, document!

Sondra Rutman is a registered nurse with more than 30 years experience in a variety of acute care settings, including two emergency departments as well as in ICU. She founded Legal Nurse Atlantic Inc. in 2008 and has since provided expert opinion on more than 50 medical malpractice cases for lawyers across the country while continuing her hospital nursing practice.

The Utilization of Data Analytics in Medico-Legal Issues at the CMPA in Emergency Medicine - Dr. Lisa Calder

Description: This presentation will review current medico-legal trends for Emergency Medicine in Canada and describe key risk management messages including how these data can be used to improve the safety of emergency care.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Describe the nature and drivers of emergency medicine medico-legal trends.
  2. Identify top 3 medico-legal risks in emergency medicine.
  3. Apply at least one practical tip to improve the safety of emergency care.


  1. Complaints to regulatory bodies are increasing –physicians can mitigate their risk.
  2. Diagnostic error is a leading cause of medico-legal complaints in emergency medicine.
  3. An appropriate, focused and well-documented physical exam can help reduce diagnostic error.

Dr. Calder is an emergency physician and patient safety researcher. She is Associate Professor with the Department of Emergency Medicine and Affiliate Investigator with the Ottawa Hospital Research Institute. She is currently Director of Medical Care Analytics at the Canadian Medical Protective Association.

Panel Discussion: Mitigation of Medico-Legal Error and Negligence in Emergency Medicine with Audience Questions - Drs. John Tallon, Steve Wheeler, Charlotte Crosbie, Lisa Calder, Ms. Sondra Rutman

Description: The panel discussion will be an opportunity for the audience to ask focussed questions about the topics presented and to explore other cases from their own experiences and to further inform the discussion.

Learning Objectives
At the end of this presentation, participants will be able to:

  1. Explore the role and experience of the expert witness in emergency medicine and lessons learned: opportunities and avenues for engagement and medico-legal work.
  2. Discuss actions against and College complaints regarding residents in the context of lessons for academic staff and teachers/supervisors of residents.
  3. Further address the role of the expert nursing opinion and the implications for emergency physicians and the importance of inter-professional communication and collaboration.
  4. CMPA: Further discussion/consolidation of emerging themes regarding medico-legal issues for the practising emergency physician.