Falls and polypharmacy

[meow1985]

I'm paranoid I am going to get sued.

I had a complicated older psych patient who fell and broke a bone, and are now in a rehab facility. I was prescribing within standard of care, but was working on minimizing medication regimen to prevent just this sort of thing. Had documented risk discussions and everything. As a certain point, patient was not eating or drinking well. I tried to prioritize addressing those things and getting them checked out in the ER for potential FTT, but didn't lower the meds at that appointment. That's the last I saw them before they fell.

Family got involved and was like, "you're on too many meds." They saw pcp and got the in house pharmacist to look at things, and pharmacist linked fall to some of the meds I was prescribing.

Patient has come back to see me and doesn't seem unhappy with me.

Are lawsuits for sequelae of falls common? I am new out of residency but had been named in a frivolous lawsuit in residency. It got dismissed, but isn't there some thing where if you get sued too many times or too often you may get dropped by malpractice insurance?

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[Ganon]

I can only speak from my experience as an RN, not a physician:

Polypharm is ubiquitous, but I've never seen a family upset if there has been communication about the direction things need to go. If you had discussions with the patient about getting off some stuff and explained why (and mentioned this in your notes) surely that has to help your case.

Again, I'm not a lawyer or physician (yet), but one thing we learn in RN school is that the medical professionals with the lowest suits are not those who make the fewest errors/practice perfect care, but those that explain everything well to patients and families, even when something goes wrong. It's one of the nice times when transparency is really helpful, and why RNs are the most trusted profession for many years running

(The flip side is that sometimes RNs share *too much* and might say things that are incorrect by going out of their depth, which this post itself may be an example of, but that's too meta and I digress.)

 

[mszzeta]

I'm paranoid I am going to get sued.

I had a complicated older psych patient who fell and broke a bone, and are now in a rehab facility. I was prescribing within standard of care, but was working on minimizing medication regimen to prevent just this sort of thing. Had documented risk discussions and everything. As a certain point, patient was not eating or drinking well. I tried to prioritize addressing those things and getting them checked out in the ER for potential FTT, but didn't lower the meds at that appointment. That's the last I saw them before they fell.

Family got involved and was like, "you're on too many meds." They saw pcp and got the in house pharmacist to look at things, and pharmacist linked fall to some of the meds I was prescribing.

Patient has come back to see me and doesn't seem unhappy with me.

Are lawsuits for sequelae of falls common? I am new out of residency but had been named in a frivolous lawsuit in residency. It got dismissed, but isn't there some thing where if you get sued too many times or too often you may get dropped by malpractice insurance?

This sounds more like a med legal topic rather than a medical one

In real practice, there is always conflicting between benefit and risk. If you don't give the patient medication, will the patient be harmed by the disease (that the medication was intended to treat) itself?