Hello all, ERP here.
What is the Quarterback offense? No, it is not some weird audible in football or a Quarterback sneak. It is a tactic used by plaintiff lawyers (and expert witnesses) to sack ER doctors in court. How does it work? Let me give you an example.
A guy I know who is an excellent ER doctor (and probably more cautious and careful than most) who was sued along with a neurologist for not giving TPA to a patient who presented with stroke symptoms to the ER within the three hour window for its use.
Now, there are MANY, MANY reasons to not give TPA to a stroke patient other than that they presented too late. The symptoms could be too mild to warrant its risks, there could be a contraindication such as having a coagulopathy, etc. Regardless, this guy presented to the ER with some RESOLVING symptoms (I can’t remember exactly but I think he had some slurred speech) that was virtually gone by the time he got put into a room in the busy ED. The ER doc assessed him quickly, and even though he thought himself that it was not appropriate to give the drug, he called the neurologist on call to run the case by him for confirmation. The neurologist agreed and the TPA was not given. The guy was admitted and, and the time of leaving the ED, he had zero symptoms. Perfect! Right?
Wrong. A few hours later up on the floor he suddenly stroked out big time and after a long deterioration, died. The ER doc and neurologist were sued for not giving TPA.
Now, this is related to the title of the post as such. The plaintiff-sponsored “expert” witness (an ER doctor whose smiling mug is frequently plastered across the pages of many Emergency Medicine magazine/journals as the “face” of a large contract management company. (Makes me nauseated)) claimed that my friend was not being a good “Quarterback” by FORCING the neurologist to come in and examine and thus administer the drug.
Now, we are supposed to send out a hit man squad to twist the arms of consultants I guess. Never mind that the guy would not have been given the drug by any prudent ER doc or Neurologist.
Well, the good news is that the jury thought this was silly as well and found in favour of the defense and my friend and the neurologist were exonerated.
What’s next? The Blitz? The Double Reverse? The Hail Mary??!??!