MEDICOLEGAL ERRORS IN THE ED RELATED TO THE INVOLUNTARY CONFINEMENT OF PSYCHIATRIC-PATIENTS

To determine the effectiveness of emergency department (ED) physicians properly and correctly completing documents required for emergency co nfinement of psychiatric patients, 1,000 Physician Emergency Certifica tes filed by ED physicians in the Shreveport, Louisiana, region were r eviewed for appropriateness and for correctness of completion based an the applicable state law. Of the Physician Emergency Certificates rev iewed 4.2% were incomplete or inappropriate, The most significant sour ces of error involved incomplete documentation of the mental status ex amination and not documenting the specific reason (dangerous to self, dangerous to others, or gravely disabled) for the patient meeting requ irements for involuntary confinement. Other errors included confinemen t for reasons not appropriate for a psychiatric unit. This study sugge sts that ED physicians should be more cautious and thorough in complet ing the documents required for emergency confinement of psychiatric pa tients, so that the physician is less likely to be sued for malpractic e or charged with the false imprisonment of such patients, and the pat ient's civil liberties are protected. Copyright (C) 1998 by W.B. Saund ers Company.