This case was interesting from a legal perspective in that the plaintiff originally failed to file suit against the NP—probably resorting to liability under the theory of respondeat superior (generally, employer liability for employee actions). While the plaintiff was unsuccessful in adding the NP later, due to the statue of limitations, the NP was brought into the case by her own practice, through a procedure known as “impleader.” An impleader action is brought by a co-defendant. Under typical impleader rules, the defendant becomes a “third-party plaintiff” and brings suit against a “third-party defendant” (in this case, the practice and the NP, respectively).
In sum, always keep important diagnoses in mind, and document well. Anticipate a changing clinical course, and instruct patients on how to respond to those changes. In certain cases, we are well served to pick up the phone, check on the patient, and make the presentation less of a static picture and more of a dynamic movie. —DML
References
1. Craig S, Brenner BE. Appendicitis (updated October 26, 2012). Medscape Reference. http://emedicine.medscape.com/article/773895-overview. Accessed August 14, 2013.
2. Yeh B. Evidence-based emergency medicine/rational clinical examination abstract: does this adult patient have appendicitis?.Ann Emerg Med. 2008;52(3):301-303.
3. Wagner J, McKinney WP, Carpenter JL. Does this patient have appendicitis? JAMA. 1996;276(19):1589-1594.