No Note, No Defense

A college student walks into a community emergency department after a reported fall. The CT shows bilateral frontal hemorrhages. A neurosurgeon directs her care by phone from home — orders are placed, but no narrative note explains the reasoning. Over the next thirty hours, the patient deteriorates through documented changes that no single provider connects. By the time decompressive surgery begins, it is near midnight on hospital day two. A diagnosis that was visible on imaging at 12:31 PM was not reported. A risk factor that fit the picture was not on the chart. Seven defendants are dismissed on summary judgment. One is left to settle. The seven-figure resolution of a case that turned, more than anything else, on what was — and was not — written down.This Substack is reader-supported. To receive new posts and support my work, consider becoming a free or paid subscriber.Thanks for reading! This post is public so feel free to share it. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit thecharteddefense.substack.com/subscribe