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Medically Cleared?

March 25, 2012

A patient makes repeated trips to the hospital emergency department for leg pain.

X-rays and ultrasounds performed and showed no abnormalities. When she is discharged, but still has pain, she refuses to leave and is arrested for trespassing. Several hours later, she is found dead in jail.
Autopsy shows she died from pulmonary emboli and had blood clots in both of her legs.
Video from the jail (available at the link) makes the police look quite bad.

One of the issues in the case is a “Fit for Confinement” report issued by the emergency physician. The police chief stated the police “depend on [those reports] to tell us [the prisoners are] OK.”

Be careful about writing “medically cleared” on any discharge form – for psychiatric patients or for incarcerated patients.

Better wording might be something like the following:

“The patient has no manifestations of an emergency medical condition at this time, but should be re-evaluated if symptoms worsen, if new symptoms develop, or if problems occur. Emergency medical evaluations do not take the place of regular medical care.”

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