Discharged from Hospital Too Early: Medical Malpractice?

A too-early discharge from a hospital or other care facility can cause as much harm as any other medical error committed by a health care professional. That means a situation like this can form the basis of a viable medical malpractice claim. Let's take a closer look at:

• common types of early discharge scenarios
• how emergency readmissions typically play a part, and
• what a patient must prove in this kind of medical malpractice case.

Common Types of Early Discharge Cases

Early discharge cases involving newborns are the most common type of early discharge case. Because of the spectrum of health issues that can occur early in life (some potentially serious), infants should remain in a hospital for the first 48 hours after birth, according to the American Academy of Pediatrics (AAP).

The 48 hour rule is a minimum guideline for healthy infants, but longer stays are recommended for infants experiencing complications. In addition to the 48 hour rule, the AAP makes a number of recommendations, primarily related to health indicators that should guide the discharge of a healthy infant from a hospital. These include:

• normal and stable vital signs for at least the past 12 hours
• at least two successful feedings
• urination and the spontaneous passage of at least one stool
• hearing screening, and
• assessment of family, environmental, and social risk factors.

Of course, adults can also suffer avoidable harm if they're sent home from a hospital or other care facility too soon. Some of the most common scenarios include a patient being discharged before adequate testing for post-surgery infection is completed, or a heart surgery patient getting sent home before adequate testing of a pacemaker is performed.

Emergency Readmissions After Too-Early Discharge

In most early discharge cases, patients are readmitted to a hospital under emergency conditions. It's important to note that the hospital need not act negligently during the emergency readmission for the patient to have a valid medical malpractice case. In many early discharge situations, significant harm will have occurred before the patient is readmitted. The key here is that patient's medical malpractice lawsuit would seek a legal remedy for preventable harm, i.e. damages that would not have occurred if the patient had stayed at the facility under direct care and observation.

(Note: While the law recognizes that mistakes are more likely in emergency situations, and liability standards attached to emergency room errors are typically a bit lenient, if the emergency situation only came about because of an inappropriate discharge, any mistake made during the ensuing emergency treatment could be attributable to the facility that sent the patient home too soon.)

Proving Medical Malpractice

The different factual possibilities for cases involving wrongful early discharge are infinite. But when patients sue for medical malpractice, courts analyze almost all cases using the same formula. Most medical malpractice plaintiffs must prove:

• medical negligence on the part of a health care provider, and
• harm caused by that negligence.

Was The Early Discharge Negligent?

The question of whether a doctor committed medical negligence in these cases boils down to "How early is too early?" That question is answered by 1) determining the appropriate medical standard of care under the circumstances— what would a similarly-skilled doctor have done under the same treatment scenario, and 2) pointing out exactly how the doctor fell short of meeting that standard.

In early discharge cases, the medical standard of care might require a doctor to:

• perform specific tests to ensure the patient is healthy
• monitor a patient's vital signs for a specific amount of time to ensure stability
• schedule a follow-up visit, or
• diagnose and treat an underlying condition.

In the vast majority of cases, proving the standard of care requires medical expert witness testimony. The same expert will usually be used to prove deviation from the standard of care. For example, if the standard of care required the doctor to wait until an infant was showing no sign of jaundice before discharging the infant, and the doctor failed to keep the infant for observation even while the symptoms were still obvious, the expert would analyze this treatment against the yardstick of the standard of care—showing what the doctor did in the context of what he or she should have done.

Was There Actual Harm?

In order to win a medical malpractice lawsuit, the patient must prove that the doctor's negligence caused foreseeable harm. This harm can take many forms, including:

• pain and suffering
• cost of medical bills
• loss of earning capacity, and
• loss of the ability to enjoy life's pleasures.

The critical issue is whether the negligence actually caused harm. It is insufficient to show that a patient suffered harm after a mistake was made.

For example, imagine a doctor discharged a cancer patient after a round of chemotherapy. The patient died shortly after being discharged. Even though the death occurred shortly after the patient was released from the hospital, it may have been perfectly reasonable for the release to take place, and the patient's family would not necessarily have a medical malpractice case against the doctor. The family would have to show that the discharge was inappropriate, AND that it contributed to the patient's death. If the death would have occurred even if the patient had still been in the hospital, the doctor would not be liable for medical malpractice.

Medical malpractice cases are complex from just about every angle. Having an experienced lawyer on your side is typically a key to getting the best outcome. Learn more about finding the right medical malpractice lawyer for you and your case.