Intro
In one recent case, a woman waited hours in a hospital ER with what was dismissed as indigestion. It turned out to be a ruptured appendix. By the time she reached surgery, it was too late. The verdict? $885,000.
This isn’t rare. ERs are facing record patient volumes, dwindling staff, and increasing legal exposure. In 2025, emergency rooms have become the most chaotic and legally vulnerable node of the healthcare system.
For plaintiff attorneys, that changes everything. The next wave of med-mal litigation won’t start in the operating room—it’ll start at the front desk of the ER.
Why the ER is Under Legal Fire
Emergency departments were never designed for long-term care. But today:
- They function as primary care for uninsured patients,
- Absorb mental health overflow,
- Navigate chronic staffing shortages,
- Operate under pressure from automation tools and triage software.
The result? Missed diagnoses, delayed treatment, triage failures — all ripe for high-value, complex claims.
“ERs are the new legal frontlines. They're fast, fragile, and full of blind spots.” — Kathryn Snapka, Medical Malpractice Attorney, Texas
The Numbers Tell the Story
- ER-related malpractice claims are up 22% since 2021.
- Nearly half involve missed or delayed diagnoses.
- The average payout for ER-related claims: $1.2 million.
Top conditions behind these claims:
1. Stroke
2. Sepsis
3. Aortic dissection
Where It Goes Wrong
1. Triage Failures:
- Vague symptoms get misclassified
- Subtle signs of major events are downplayed
2. Documentation Gaps:
- Time entries missing
- Notes altered post-incident
- Conflicting physician and nurse notes
3. Breakdowns in Handoff:
- Shift changes
- ER to ICU/OR gaps
4. Protocol Overreach:
- Overreliance on checklists
- Misapplied pathways (e.g., migraine vs aneurysm)
What Attorneys Should Do Differently
1. Request EMR Audit Trails Early
- Show what was accessed, changed, and when.
2. Use ER-Specific Experts
- Specialists who know triage systems and ER workflows.
3. Reconstruct a Real-Time Timeline
- Use vitals, chart entries, staff movement, and logs.
4. Evaluate Staffing Ratios
- Prove that systemic understaffing contributed to the delay.
5. Focus on Delay, Not Just Mistake
- Prove the harm wasn’t in the act, but in the wait.
The Juror’s Perspective
Jurors expect ERs to be busy. But they also expect:
- Nurses to escalate red flags
- Doctors to pause when something doesn’t add up
- Systems to function even under pressure
When those expectations are betrayed, the emotional response is strong.
“The ER isn’t exempt from accountability just because it’s hectic. That’s where it matters most.” — Tom Crosley, Trial Lawyer, Texas
Final Thought
ER malpractice claims are rising for a reason: the system is under strain, and patients are paying the price.
As plaintiff attorneys, we can’t treat these as routine med-mal cases. They demand faster review, smarter expert selection, and a deeper understanding of hospital systems.
Because the ER is where the story begins—and in 2025, it’s also where the next landmark verdicts will be written.