When to discharge a patient from a hospital or other medical facility is a tricky decision. It requires a balance of many factors, and there is a lot of room for error. If a patient is discharged too early, there could be serious consequences, such as worsening of a condition or symptoms, infections, pain, and even death in some of the worst cases.
How doctors and medical teams determine discharge for a patient is complicated, and not all mistakes made in the decision are considered negligent. However, there are many instances in which it can be proven that a poor decision about discharge was made, and that the early release led to damages and could be proven to be medical malpractice.
What is Premature Discharge?
Premature discharge refers to any case in which a patient is released from a hospital or other type of medical facility before it is reasonably safe to do so. This early discharge may occur in an emergency room, intensive care unit, or other department in a hospital. It may occur in a psychiatric hospital or residential facility, a drug rehab facility, or a nursing home.
There are many factors that go into deciding when a patient should be discharged and it can be complicated. Many hospitals have checklists that must be followed to avoid premature discharge, but there are many individual factors that must be taken into account and that can’t be found on a checklist. When discharge is determined to be premature, it is after the fact, often when the patient needs to be readmitted soon after or when the patient suffers some type of harm that could have been prevented if they were still in care.
What Causes Premature Discharge?
With a complicated decision like choosing a discharge date, there is a lot of room for error and making mistakes. A patient may be discharged too early simply because of logistical and financial reasons. A hospital is often under pressure to keep costs down and to open up more beds for patients who need them. This can lead to poor decision making in terms of discharge.
In other cases it may simply be a matter of carelessness. A doctor or a team making the decision for discharge may follow to go through all the required steps on the checklist or may not take the time to really get to know the patient and get his or her input on being ready to leave. There may be tests that were missed or a failure to completely assess a patient before making the discharge decision. The physician making the final choice may not take the time to consult other members of the team or specialists who can provide unique insight into the patient’s state and readiness.
Then there are errors that can lead to premature discharge. For instance, equipment may provide incorrect readings that make the patient seem to be in better health than is really the case. A lab error could lead to a mistake that causes a doctor to discharge a patient too soon. Or there could be an error in the patient’s records and documentation. There may even be a mix up between two patients.
When Premature Discharge is Medical Malpractice
Proving that premature discharge is medical malpractice means proving that a doctor or hospital did not meet all standards of care in making the decision. It needs to be shown that a similar doctor or medical team in the same situation would have done something differently in providing reasonable care. The patient must also show that the premature discharge led to harm and significant damages, such as readmission, more medical bills, pain and suffering, or a worsening or new condition.
The Consequences of Premature Discharge
If a patient is sent home to early there could be a whole range of consequences. Studies have found that readmission is one consequence of early discharge from the hospital. They have also found that about 25 percent of those readmissions could have been prevented, often by choosing a later discharge time or date. Readmission is not desirable because it is more costly, exposes patients to the risk of infection, causes more distress, and keeps a patient away from home, work, and family for longer.
Other consequences of premature discharge are even more serious. In the worst case scenario, an early discharge leads to patient death. A study found that when patients are discharged prematurely from the intensive care unit (ICU) in a hospital, mortality rates go up. The risk of dying for ICU patients is higher for those who are sent home or are sent to a lower level of care too early.
Examples of Premature Discharge Malpractice
Deciding when to discharge a mother and baby after childbirth can be tricky when there are complications and in many cases the discharge is found to be negligently early. In one case a premature baby was discharged just two days after being born. The baby suffered from severe jaundice, which ultimately led to brain damage and cerebral palsy, a permanent condition. Longer hospitalization and treatment could have prevented the damage and the family won a $4 million settlement from the hospital as a result.
In another sad case involving a child, a four-year-old girl was discharged from the hospital just hours after being admitted for injuries caused by a dog attack. Soon after returning home she suffered from a stroke caused by a blood clot and was readmitted to the hospital. She suffered from paralysis and vocal cord damage because of the stroke, and her family is now working on filing a lawsuit to prove that she was discharged too early and that the hospital should have done more to prevent the clot that caused the devastating stroke.
Premature discharge can be very serious, leading to readmission or worse. Patients and their families need to be proactive and to advocate for themselves to help prevent premature discharge, but ultimately the responsibility falls on the hospital and medical team. If you feel you were the victim of a premature discharge, you may want to consult with a medical malpractice lawyer to determine if you have a solid case.