Care In Chaos

Voiceover: Every minute someone’s life takes a terrifying detour not down a dark alley, but into the sterile, bright halls of healing. They walk in, seeking care and find themselves plunged into a nightmare. Most malpractice claims in hospitals are related to surgical errors, whereas most claims for outpatient care, which accounts for more than half of the paid malpractice claims, are related to missed or late diagnosis. 

Now, before you raise a pitchfork at every white coat you see, let’s be clear this isn’t an indictment. It’s a revelation. Because the truth is, any provider, any nurse, any human being capable of brilliance is also capable of a mistake. This is about understanding why and using that knowledge to build a safer future for every patient who walks through those doors. 

Welcome to Scrubs and Subpoenas: Tales from the Witness Stand, a podcast where we’ll peel back the sterile sheets and delve into the real stories of medical malpractice. Each episode a cautionary tale, a blueprint for change. A reminder that even in the darkest corners of human error, there’s a light. The light of knowledge. The light of empathy. The light of a future where health care becomes not a gamble, but a guarantee. 

So, join us as we dissect the mistakes, illuminate the flaws, and ultimately learn to heal, not just bodies, but the very system itself. 

Jannah Amiel: Hello and welcome to another episode of Scrubs and Subpoenas: Tales from the Witness Stand. I still really want thunder when we say that, so maybe we can ask the production team about that. Anyway, welcome back, Dr. Miller, how are you? Thanks for joining me.  

Sally Miller: I’m very well. Thank you. Thanks for having me.  

JA: Absolutely, absolutely. And to all our listeners, thanks for tuning in to another episode. 

We’re excited to have you, as always. For those of you that are tuning in for the first time and didn’t listen to our wonderful answer that we have, remember that we’re going to talk about real medical malpractice cases, right? Breaking them down, breaking them apart, trying to understand what happened, maybe why, where, when, and the takeaways that we can use in our own practice just to be a little bit better, a little bit safer, right. 

A little reminder of what we’re doing and why it’s so important. So, with that said, I’m going to turn it over to my very esteemed guest, Dr. Miller. I’m very excited about this story.  

SM: Well, good morning or afternoon or whatever, whatever time it is, I honestly don’t remember, but I guess for anybody it could be any time zone anywhere. 

So, this case is about if-this is the psychiatric mental health nurse practitioner is the person that is being, you know, that is the person against whom the complaint is made. So, like we usually do, I’ll tell you a story. I’m going to try not to be too schizophrenic about it here, but just to try- 

And I’m reading from my notes. I realized later I probably always look like I’m looking down because I’m reading from my notes. Just because, I mean, not just my notes, but like copies of notes from the chart. Because I want to give everybody all the real info and not sound like I’m slamming it to my opinion. I mean, at the end, of course, I have an opinion. 

That’s what I get hired for in these things. But it is really important to take the facts of the case at hand and look at them in an objective way. Because any expert witness, it doesn’t matter whether the plaintiff retains you or the defense retains you, you can’t go into it with that perspective. You have to go into it objectively. 

And if you read a case and you cannot support the position of the person that retained you, then you have to tell them that. And I’ve done that too. You know, there have been times where it’s like, ‘Look, this person just didn’t do anything wrong. I can’t support that.’ Or, ‘Oh, like this doesn’t look-this really I can’t defend this action.’ 

So, we look at it objectively and then we can form an opinion. So, this is a story about a 34-year-old man who was admitted to an inpatient psychiatric facility, and the nurse practitioner who ultimately was managing his care during the events that mattered. So, to read my notes to you, the patient had long history. He was 34 years old at the time of events, but he had numerous psychiatric diagnoses, numerous episodes of psychosis. 

These first became apparent in adolescence. So, he has a 20-year history of psychosis, you know, of psychotic episodes and numerous psychiatric diagnoses. He had been hospitalized numerous times throughout young adulthood. Repeated documentation of aggressive behavior, interactions with the criminal justice system, including incarceration. He had been on probation, so his diagnoses led to criminal behavior. And there was a long-established pattern of it. 

The diagnosis he carried to this admission were schizoaffective disorder, which is a combination of schizophrenia along with a mood disorder, it could have been bipolar disorder or a major depressive disorder. Oh, it was bipolar type. So, schizophrenia, bipolar disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and polysubstance abuse dependence. And now sometimes, just like in any other setting, sometimes these diagnoses just sort of get thrown at people in acute circumstances. 

And they may not all be current or all actually be accurate or supported, but those were the diagnoses that were on the chart. So, what everybody knew for this patient coming into this particular hospitalization is that he had a long history of being aggressive and violent and criminal convictions and incarceration and a variety of both psychotic and neurotic diagnoses, as well as substance use. 

He also had a documented history of suicide attempts. He had been convicted of violence, including convictions for domestic violence with the use of a weapon. So, anyone who approaches this patient has to be aware of that, because safety first, you know, it matters. So, the patient, at this time, he was 34 years old. And on this-the events that matter, he was admitted to a behavioral health center as a direct transfer from a regular hospital. 

So apparently, he had had some outburst or some events. He was taken to a hospital and then they sent him to the behavioral health hospital. He had very recently been discharged, like 3 months prior. He had been discharged from an involuntary hospitalization and following a court ordered conditional extension. So, the court ordered him into care, and then they allowed him to be released pending very intensive, aggressive outpatient follow up and monitoring by the criminal justice system. 

So, that’s how he happened to be home, even though he had this very recent history of violent behaviors and, that were attributed to psychosis. So, there’s a lot going on there. Anyway, he went home. He went home with his mother, his condition rapidly deteriorated, and then he was sent back to behavioral health. Three months later, he failed to demonstrate improvement. 

And then he was sent to the place where he is now. So, that’s what’s going on. His admission history and physical examination at that point documented an uncooperative patient with deteriorating psychoses. So, that was his condition on admission. So, because I feel like I sound schizophrenic, let me just like pull it back for a minute for everybody who’s listening. For 20 plus years, this man has a history of psychotic episodes, of aggressive episodes, of OCD, and substance abuse and criminal behaviors. 

He had been in and out of the, you know, in and out of inpatient facilities on and off for years. He had had suicidal attempts, but most recently he had his most recent conviction. And then, as a consequence of some judicial-mediated supervised mission to try to ensure care, he had been allowed to go home with close follow up and, you know, following by probation and mental health. 

And he was with his mother for a couple months, but he rapidly deteriorated and wound up back in the hospital. And when he got to the hospital, he was uncooperative. He was psychotic. He reported that he had been hearing voices telling him not to take his medication, that the voices sometimes told him to kill himself. We know he has this history of aggressive behavior, and in this admission, it was documented specifically of kicking doors, punching walls, throwing a bottle of water at the staff, becoming fixated on some of the female staff members. 

So, that’s where he is today in the hospital. And we know that he’s on probation for domestic violence, for assaulting a, not a wife, but a family member. He had held down his sibling and put a knife to her throat. So, that’s the circumstance when he’s in the hospital right now. 

So, on his admission, his physical exam documents that he has agitated. He has an order for restraints as needed. He had been nonadherent to his medication regimen while he was with his mother, which is, of course, why things deteriorated. So, on this admission, they resumed his medications, which included topiramate or Topamax®, which is antiepileptic medication that we don’t- 

I’m kind of surprised. I don’t know what exactly it was for. I mean, sometimes we use those antiepileptic drugs as mood stabilizers, used for anxiety and depression. But Topamax really isn’t one of the first ones. But anyway, he was on that. He was on trazodone, he was on clonidine, and he was on Invega® intramuscularly, which is the antipsychotic. 

At the time of the admission, there was also a PRN protocol initiated for Haldol, Cogentin®, Ativan, and Benadryl®.  

JA: Oh, I know that cocktail.  

SM: So, for those of you who don’t routinely load that cocktail mixer for things that routinely work with a psychiatric and a psychiatric facility, I mean, Haldol is a first-generation antipsychotic. It’s funny. It’s got this reputation of being au Haldol, but it’s a first-generation antipsychotic. 

I mean, it may have side effects like sedation, which in this case we would like, but it does control psychosis. I mean, the only reason we don’t like to use Haldol so much now is because of the adverse effect profile in the sedation. But in that circumstance, you want to capitalize on it. The Cogentin for the extrapyramidal effects, the Ativan is the benzo for, you know, to immediately calm somebody down. 

And then Benadryl as an added agent to promote, you know, calming. So that was the PRN cocktail. Just a, you know, like sort of a, you know, like when you admit somebody to all sorts of units, there’s standing orders that are commonly used and this as that. So, he was admitted. He did not respond well to treatment. 

He obviously didn’t like being there. He didn’t want to be treated during his hospitalization. The documentation, it appears, that he remained isolated. He was uncommunicative. No insight into his diagnoses. I mean, many patients with psychiatric diagnoses, once you acutely calm them down and you get past that acute agitation and psychosis which Haldol and Ativan will do, they often do recognize that they have psychiatric diagnoses. 

I mean, they might hate their medication. They don’t like the side effects. But I would say the majority do know that they have a condition that needs to be treated. They just don’t like it. But there are a fraction of patients with psychiatric diagnoses that lack insight. There’s actually a medical-there’s a diagnostic term for it, and they’re the hardest to treat because lacking insight just makes it impossible for them really to engage in therapy. 

And they’re always very resistant to taking medication. So, this man was like the hardest of the hard to manage, from his admission through the next 10 days, nursing notes consistently document that the patient remained isolated, not participating in Group. On one day, he presented to the nursing station demanding medication for GERD. He then became agitated and symptomatic, and he had to get his protocol, Haldol, Cogentin, and Ativan. 

And 3 days later the patient, they attempted to have him see the psychiatrist in the facility. The details aren’t documented, but apparently the patient ultimately refused to leave the office, and he had to be carried away in a chair. Now, this is a 34-year-old male over six feet. I think it was about 250 pounds. 

JA: Oh, my God.  

SM: He had to be carried out. Again, he was medicated with the cocktail of Haldol, Benadryl, and Ativan. From those two events, when he went to the nursing station asking for medicine for GERD, and when he refused to leave the psychiatrist office, then the nurse nursing notes really just consistently document a patient who is isolated, no proactive contributions to care, and no participation-now, in an inpatient psych facility there’s always Group that they want people to go to.  

There’s a variety of ancillary services that will, you know, social work usually comes in to try to work with you. So as indicated, OTP, all that kind of stuff. And he just wasn’t interested. So, he was in the hospital for a total of 17 days. And all of these things happened about halfway through. 

So, then on the morning of the 17th day, there was documentation that the patient was at breakfast in the dining room, which was unusual. But then after breakfast, he went back to his room, slammed the door and was unresponsive to the psychiatric technician’s query as to his well-being. That’s the way it was documented. Shortly thereafter, the patient comes out, goes to the nurse’s station to apologize for his behavior. 

Then he goes back into his room. Between like 8:30 and 9 in the morning, approximately, there is documentation after he apologized. So, he went to breakfast early. He went to the dining room, which is odd. Then he went to his room and slammed the door. Then he wouldn’t respond. Then he came out to the nurse’s station to apologize. 

Then he went back in his room and shortly thereafter staff heard a loud bang in the room, and when they went into the room, the patient was documented as “out of control, kicking garbage cans, the linen cart, throwing his own feces at people.” 

JA: Oh, my.  

SM: Notes further describe that he was flipping tables and chairs. Documentation indicates that he attacked a staff member. 

So, at approximately 9 a.m., 911 was called by facility staff and an emergency was called in the facility. So, the patient was contained by staff in a prone position. Now remember, he’s violent, he’s kicking, he’s big, he’s turning over tables. He’s throwing feces. So, they call 911. And facility staff manage to keep the patient in a prone position, pending the appearance of someone that could appropriately restrain him and then take, you know, take him out in the ambulance. 

So, everybody getting the picture here, we have this clearly unstable, violent, dangerous patient who is now just really started acting out in a psychotic way. Several staff men, he’s already attacked one staff member. Other staff members are holding him down, and they’re just waiting for an ambulance. So, when all of this happens, of course, you know the provider on-call-the ranking provider on-call- 

This was a Saturday morning-is going to be called to the scene. And it was the APN. This APN didn’t know the patient. She just covered weekends there in this inpatient psychiatric facility. And so, she is notified that they have this, you know, dangerous situation. And an ambulance has been called. So, she comes to the scene as well. 

So, when she gets there, she, you know, tells them to go ahead and give his protocol, his Haldol, Benadryl, Ativan, and Cogentin. And the progress note reveals that the patient remained agitated even while all this is going on. He was trying to, you know, get away from it and being resistant to his medication. So, he was restrained in this position, continued to struggle violently. 

Then he was given his medication and the ambulance staff arrived and the patient stopped struggling. When he was turned supine, he was found to be apneic.  

JA: Oh.  

SM: From prone to supine, he was found to be apnea. 911 was already there. EMTs were already there, and they commenced cardiopulmonary resuscitation for about 40 minutes, when he was finally pronounced dead. 

JA: Oh holy crap.  

SM: So, oh, horrible story, horrible story.  

JA: Oh, shoot. Yeah.  

SM: So, can you guess? So, I said the APN, whose poor soul didn’t even know this patient just got up to probably go do her weekend, you know, make a few extra dollars. So, how did she get in? And this happens on a Saturday morning. So, any guess what the complaint-again just you know, any kind of any guess what the complaint against her might be? 

JA: That she ordered that while he was prone, like she snowed him out and made him go into arrest. 

SM: It was-I mean, it was-there was a stretch of the stretch, really, but the real like, this is all on video, by the way. Like there’s video evidence of this and there’s a bunch of, there’s, you know, people milling around. There’s like several staff holding the patient down. There’s other staff members, of course, there’s patients there trying to get them out of the way, but there’s patients watching. 

And then the EMTs arrive. So, there’s the ambulance staff. There’s the nurse that the patient assaulted, and she’s sitting there. She needs care from the EMT providers as well. I mean, she was, you know, she was okay, but she had like a pretty serious gash on her face or something. I think they were worried about a fracture. So, there was a whole lot going on. 

And the APN was the ranking person on the scene-like that-you know, person like the nurses, the tech staff. This is where I was gonna look to for their orders and stuff. So as you look over, if you look at the scene on the video, it looks it looks a little chaotic, not overtly, but definitely like this is not something they’re really accustomed to. 

I mean, you might think in an inpatient psych facility would be, but not really to that extent. And this is a big guy. The primary complaints, the complaints that they lodged against the APN was that apparently at one point the patient said while he was struggling, you know, he was prone. He was struggling. He said, “I can’t breathe.” 

The APN in her deposition said she didn’t hear it. He said he can’t breathe. But then he kept struggling. So, at that point, he was breathing enough to struggle against three different people holding him down.  

JA: Yeah.  

SM: And then later on, you know, a few minutes, not a few later, but a few minutes later again, he said, “I can’t breathe.” 

And she heard that. And you can see, like in the video, you know, the head turn. And so, when he said that, she instructed the staff to turn him over.  

JA: Yeah.  

SM: And then when they turned him over, he was not breathing. So, the complaint against her was that she didn’t intervene soon enough when he said he couldn’t breathe and that apparently on autopsy there is some suggestion that he was overmedicated. 

I don’t remember the details because at this point it didn’t matter to me. It wasn’t, you know, relative to what I was being called for. But there was some concern that he had been overmedicated with the benzo, like the wrong dose. And he-and so the complaint against the NP was that she ordered that without assessing the patient first and that she didn’t go into the medication room and watch the RN draw up the meds. 

JA: Surely you don’t mean assessing while he’s thrashing about. Surely not. Then am I assessing anything? My assessment is he is thrashing about.  

SM: That was the assertion that she ordered the protocol without assessing the patient. 

Well, here’s an assessment of a man who’s clearly having a crisis right now. He’s dangerous.  

JA: Dangerous? Absolutely.  

SM: And I don’t know how much assessment you need of somebody that needs three people to hold him down. And what else I would do is I said, like- 

JA: Honestly, what would you assess in this scenario without putting yourself at risk? 

SM: And I don’t mean to laugh. It’s not funny. And the patient died and that’s not funny at all. But I’m just trying to imagine, like for-to administer Haldol and a benzo, what would you assess? In a perfect world, I guess their mental status and their vital signs. But again, you’re not going to get vital signs. 

And someone who, you know, remember the history, the course of the events. And all of this, of course, is provided to her. She’s you know, she’s standing there, you know, she’s standing there. And the nurses that know the patient and are familiar with the chart are sharing the history. He’s got a 20-year history of intermittent psychosis, violence, criminal violence, assault with a deadly weapon. 

He has assaulted the, you know, staff. He had to be carried out of the psychiatrist’s office that morning. He got verbally abusive with the staff. He was flipping cards, flipping tables, throwing feces, had to be restrained. I mean, if three people are holding him down, what reasonable standard of care would expect for you to say, ‘Okay, everybody, let’s get his blood pressure right before we get-’ I just-it’s just impossible. 

It’s ludicrous. Like, this is what’s so disturbing about our system. I mean, I totally do believe in when someone really deviates from a standard of care and the patient has a poor outcome, that there should be a remedy for that. I mean, I’ve testified, I have testified to support plaintiffs when an NP really deviated from standard of care and should be held accountable, the patient should be made whole. 

But I just look at this and go, how, who could ever-now, in this case, I am happy to report they did not have an NP for the plaintiff. I don’t know if it’s because they couldn’t find one. Maybe just everybody they contacted had some integrity. They had a physician opining about the care of the NP. We’ve talked about this before, like how slanted the system is for every other malpractice case, only the same discipline can opine about that discipline PT for PT, OT for OT, NP for NP. 

But a physician can opine on anyone. So, that’s just an anomaly of the system that really needs to be-that’s a different task, like do after hours oh three to like the assertion that the NP should have watched the RN draw up the meds, what prescriber ever in any parallel universe, gives an order and then follows you into the med room? 

They’re usually not even there. It’s like a phone order. Or they write orders and make their rounds and go away like no prescriber does.  

JA: The fact that they RN has the license means that she can do that, or he can do this.  

SM: So, the physician said that the NP should have watched the RN draw up the meds, and the physician said that the NP didn’t intervene fast enough when the patient said he couldn’t breathe. 

Now, I guess that’s you know, anybody can make that decision. But if she heard him or not and purposely ignored it, if you watched the video you can tell like there was not even a flinch. It was so much going on, you know, here’s the EMTs. The patient’s thrashing. They’re holding him down. The NP is being, you know, given information by the aunt and the LPNs and the techs and stuff. 

So, I mean, it makes perfect sense that in the midst of all of that, the first time he said, “I can’t breathe,” she didn’t hear it. Who knows what else was going on? Like some-like a stretcher rattling or whatever, but, but then you can tell like seconds later, you can tell that she turns her attention to the ground, like the patient. 

Calm down. You know, I mean, he was not breathing, but the patient sort of relaxed. Things quieted down and she heard him say, “I can’t breathe.” And she did. You know, she had them turn him over, and they did right away. And unfortunately, he was apneic. But again, in terms of standard of care, who I mean, how so? 

Like, how does this go different for an employee, for any provider? Like what would you have done differently? Grant it to your point. I think you’re right. Like if you heard him say that he couldn’t breathe, certainly you want to act on that, right? You want to act on that. If she didn’t hear him, I can see how that can be possible in this type of scenario. 

And then I’m thinking, if it was an issue with the the he had too much drugs or he had too much of the barbiturate, couldn’t they measure that in the autopsy to say yes or no? This was toxic level or not to like had something like really like conformational. There was you know, again, that’s not my area of expertise either. 

So, I don’t know about how fast things deteriorate, you know.  

JA: Yeah.  

SM: Like when time goes by and then when a body is not functioning anymore, I reapplied. But I remember from, you know, from the autopsy report there, it was not crystal clear, but there was some suggestion. Yeah, there was some. Yeah, there was some insinuation, but that like, that’s its whole own science. 

I mean, I’ve seen plenty of cases where it comes down to were they toxic on this drug. And there’s different experts that have different opinions. And I don’t know enough about it to say, like, once, you know, for me, the question was, should the NP have watched the RN draw it up? And I said, ‘Well, first of all, no.’ 

But further, are you suggesting that she should leave the patient and leave the events to go into the medication room? And even if and normally she would have watched her draw it up, which is absurd. But even if you would have done it at that point in time, you would stay with the patient. So once that was you know, that was my piece of it. 

It really wasn’t for me to get into the different levels of drugs and how you break it down. So, you know, again, I don’t know how it all shook out, but I know that the assertions against the NP. So, what happened with this case is this, this NP like, go all the way. Yeah. No, the NP that was actually dropped from that, it never even went. 

Oh gosh. Never in the state. Like that’s what happens in the beginning of the case. You know, if-I don’t mean to make it all attorneys sound bad, I’m sure that somebody who hires me one day will see Scrubs and Subpoenas because part of their job is to research you on the internet and find out if there’s anything controversial. 

So, for anyone who might hire me one day, I really am sincere when I say not all attorneys are bad. There are actually, there are two plaintiff’s attorneys that I have worked with several times, and they really like-they take good cases. And in fact, the one attorney, there was one time where he said, ‘What do you think about this?’ 

And I said, ‘No, that person didn’t do anything wrong, didn’t do anything wrong here.’ And he respected that opinion. So, like these two and I’m sure there are lots of others, they accept cases where there clearly is a deviation of standard of care. And in that case, I-absolutely I’m glad that the patient has them to advocate. 

So, we like to make jokes about attorneys make better positions too. But there’s plenty of good ones out there. But I forget where I went off on that train of thought. Anyway, in this particular circumstance, I don’t know what else happened. I don’t know if they pursued the business of was the patient over medicated? Was there a murder or something like that? 

But I just know from the perspective of the NP there was no deviation from standard of care. So it never lo I know and I started to say it was in the beginning, a lawyer gets a hold of the case. That’s why I defended myself about lawyers. A lawyer gets a hold of the case and it might be a good lawyer, or it might be Better Call Saul member from Breaking Bad, you know. 

JA: Yeah.  

SM: So, how lawyer gets a hold of the case. And typically what they do is like-so, everybody that ever came in contact with a patient as Jane Doe, John Doe, Jane Doe, John Doe, and then they bring in experts to review the case. And then as the experts review the case, it’s like now this one didn’t deviate. 

No problem here. And then different people get dropped out of the case as it progresses. And that’s what happened here. Yeah, I imagine everyone just kind of just sitting shaking waiting to be dropped from a case. And they say that and you know that’s the heck of it. Like it is-it’s scary. I mean I’ve, I have had papers served. 

I have been served in cases, but thank God like immediately dropped like never even went to, you know, it’s like the first time an expert reviewed it on that day. At that time, my documentation was on. So, it never I mean, I’ve been named and then I’ve been, you know, dropped as the case goes forward. And sometimes there really are good causes of action against people, but not like-we were talking about the NP, I don’t know, I hope everybody watched the episode of the NP that evaluated the patient. 

The leg in duration.  

JA: Yeah.  

SM: And sometimes it doesn’t get dropped until the very end. But that’s kind of what we do.  

JA: So, wow. Quite, quite interesting. So, wait a minute. Who initiated this lawsuit. Was it his? I’m asking if it was his mom. Just remember his mother. He lived with this. Yeah. His mother. Yeah. Oh, yeah. 

SM: Like, you know, whoever is their, you know, their next of kin or power of attorney can initiate a lawsuit. And I’ve even seen cases drag on to where the patient died. And then the person initiating the lawsuit died, and then their whoever is inheriting their estate, like, kept it going. I was involved with one suit for- 

JA: Oh, my gosh. 

SM: I can’t even tell you how many years. It was-like the patient lived for a couple years on, the patient died and then the patient’s spouse died.  

JA: Oh, man.  

SM: Somebody else took it over and we were waiting for the whole population to die. Oh my gosh, that sounded so wrong. But yeah, but-and that that sounded bad. 

But you know what I mean? Okay. It can go on. Like, I guess people inherit the rights to that or something, I don’t know. Oh, I don’t, I don’t want that. I don’t want that. It just makes you afraid. Makes you afraid to see patients. But I’m telling you, do the right thing. Your care is consistent with standards of care and documented. 

JA: Yes.  

SM: And really, I mean, you know, we read about the cases where, oh, an NP was sued for millions of dollars or whatever, but the vast majority of the time that doesn’t happen unless there really was a deviation and the patient should be compensated or made whole. Absolutely. And I think it always comes down to that. And that’s a great takeaway. 

Like documentation, standard of care, you know, doing the right thing. And these stories really do end up boiling down to those pieces. So, I think that’s a great takeaway.  

JA: Yeah. Well thank you for sharing this. I know there’s a ton of listeners and viewers that have wrote in, called in seeing us at conferences and was like, give us this like story. 

So, this one is something that I think is going to be really, really something. Thanks for sharing that.  

SM: I mean, I have several out there. I just have to wait for them to come to some conclusion before we can discuss them. I can’t talk about them while they’re ongoing, so stay tuned. There will be more cases coming. 

JA: That’s right. Wow, this one was kind of gave me chills a little bit. Thank you for your time, Dr. Miller. Appreciate it, appreciate it. Sorry to hear, you know, the outcome. It’s terrible for that for that guy. But that’s-there’s a lot to takeaway there. Appreciate you all for listening. We hope you enjoyed listening to these episodes. 

And if you want to check out more then head over to FHEA.com. We got all our podcasts there or you can listen anywhere that you like to listen to your podcasts, Spotify, Apple, any of those good stuff. And until then, goodbye for now. 

Voiceover: Thank you for listening and learning with Scrubs and Subpoenas: Tales from the Witness Stand, presented by Fitzgerald Health Education Associates. Please rate, review, and subscribe to this podcast, and for more NP resources, visit FHEA.com. Join us again next time as we dissect more medical malpractice cases.