The riskiest disease in all of EM is a thoracic spinal epidural abscess causing low back pain.

1) beginning symptoms are so vague there’s no way to catch it
2) they have multiple visits and you’ll become mentally biased once you realize it’s their 3rd visit in 5 days
3) they’ll say “my legs won’t move” but you’ll see them stand and say “ha! caught you faking!”

4) a few of you will order back imaging, most will get X-rays or CTs that won’t ever see it
5) a few will actually order an MRI... but oops you ordered a lumbar one and remember, that’s not where the lesion is so look... a normal MRI. “I knew they were faking it”

6) by the time they become paralyzed it’s too late to fix it
7) you attorney will make you settle this for millions because you missing it over many visits and ordering the wrong test and accusing them of faking makes a jury very mad

The only reason I haven’t missed one is because none of my patients have ever had one. They’re almost impossible to catch while there’s still a chance to do something about it.

I don’t even bother writing up these lawsuits anymore. They’re everywhere. Your patient will become paralyzed and you will settle, end of story.