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Mon Nov 29 23:14:32 GMT 2004

In a message dated 11/29/2004 5:36:11 PM Eastern Standard Time,  
mmackinnon at cox.net writes:

While I  agree with both of you on the point, there is no doubt that
potential  injuries can be differentials based upon mech. After all, it takes
the mech  to cause the injury. Who is willing to take the medico-legal
liability for  that change? 

This is hogwash--what medico-legal liability exactly are you talking  
about--please specify it for us. Any medicla literature or case law to  support your 
implication that there is any liability at all for not taking  mechanism into 
account in trauma?  If you can  not cite any for us,  then at least think to 
yourself about how unsupportable is such a ridiculous  assertion.
 In fact, to answer your question, I take this "liability" almost  every day 
in our level I center--my decisions to discharge or admit patients, or  in 
accepting all the garbage we get "referred" from outside by docs who simply  
don't like to get up at night to--horrors!--evaluate a patient in need, do  not at 
all take into account mechanism of injury, but only the actual injuries  or 
lack thereof in front of us.  I have yet to have a single case of  liability 
myself, or have heard of any, in 20 years of practice in Trauma.   Why?  Because 
we know, from actually having to be accountable and make  these decisions, 
and being the only ones among all of us on this list who  actually follow 
patients their entire course, see them in followup and know the  outcomes and how 
they relate to mechanism--or don't.
Waiting for your supporting data that backs you  up......................
ERF

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