It's the most wonderful time of the year... unless, of course, you happen to find yourself in a hospital.

With few exceptions, most people would agree that there's never a good time to find yourself in a hospital. However, if you're a patient, there are some times that are worse than others.

In this blog post, I explain why patients visiting emergency rooms during the holiday season may be at risk for poorer outcomes compared to other times of the year. I discuss whether an unexpectedly poor outcome is evidence of medical malpractice on the part of doctors, nurses, and/or hospital administrators. And, I conclude with some reasons why it's worthwhile to consult a medical malpractice lawyer if you are uncertain about whether you or your loved one was harmed by medical providers.

The Weekend Effect.

More than two decades ago, researchers analyzed statistics from almost four million consecutive hospital admissions in Ontario over 10 years. They discovered that among the 100 most frequent causes of death among patients, almost one quarter were associated with higher mortality when a patient was admitted on a weekend.

This phenomenon, dubbed the "weekend effect," has been the subject of numerous studies. The exact mechanism(s) that cause the weekend effect remain disputed, but some possibilities include:

  • Reduced staffing and/or staffing by less experienced workers on weekends leading to poorer assessments and/or patient monitoring.
  • Limited or delayed access to specialized diagnostics or therapeutic procedures that delay treatment of time-sensitive or high-risk conditions.
  • Patients presenting hospitals on weekends may have multiple conditions or more severe conditions compared to those being admitted on weekdays.

The Christmas/Holiday Effect.

Weekends are not the only periods when hospital admissions have been linked to poorer outcomes. Excess mortality and statistically significant differences in patient care have also been noted during holidays, and particularly during the two week period around Christmas and the New Year.

According to a University of Toronto study of more than 200 Ontario hospitals between 2002 and 2016, patients who are discharged during the holidays have a higher risk of death and/or re-admittance compared to patients released in November or January. These patients are also significantly less likely to receive proper follow-up care. Patients with serious conditions, including heart failure and chronic obstructive pulmonary disease, are worse off in terms of outcomes.

Some common reasons for admissions to hospitals during this season include:

  • Slips and falls due to icy conditions that frequently result in back injuries, head injuries, and broken hips or other broken bones.
  • Falls suffered from putting up Christmas lights.
  • Lacerations that occurred during cooking holiday meals or opening gifts.
  • Gastrointestinal illness caused by improperly stored, cooked or handled food.
  • Severe burns from cooking or candles.
  • Heart failure caused or exacerbated by eating unusual amounts of fatty or sugary food.
  • Injuries caused by intoxication, and particularly motor vehicle accidents.
  • Worsening mental health leading to severe/acute depression, anxiety, and attempts or thoughts of suicide.
  • Contagious illness such as influenza/COVID-19 spreading through travel and indoor gatherings

Is an Unexpectedly Poor Outcome Evidence of Medical Malpractice?

Ideally, anyone and everyone who seeks assistance at a hospital for an injury or illness will be seen in a timely manner, assessed and diagnosed properly, receive the appropriate treatment and care during a hospital stay, and the necessary follow-up care once they are discharged.

Unfortunately, this is not always the case. From underfunding healthcare, to overcrowding in hospitals, to human error, there are many reasons why a patient may suffer preventable harm while seeking medical assistance.

In some cases, negligence on the part of hospital staff or administration is the cause or a contributing factor to a poor patient outcome. In other cases, despite providing a patient the appropriate standard of care, the patient will not recover as well as might be hoped.

Determining if a poor outcome is evidence of medical malpractice is complex and fact-specific. However, if you or a loved one was treated in an emergency room during the holidays (or at any other time) and your prognosis took an unexpected turn that resulted in a serious, debilitating injury or death, it is worth your time to speak with a medical malpractice lawyer to learn if you might have an actionable claim.

How Can a Medical Malpractice Lawyer Help?

To make a successful claim for damages due to medical negligence, a plaintiff must prove that:

  • There was a patient relationship between the plaintiff and the doctor/medical staff/hospital administration.
  • The doctor/medical practitioner/hospital fell below the standard of care expected of a reasonable person in their position given the same set of circumstances due to negligence.
  • The breach of the standard of care caused or contributed to damage that would not have occurred in the absence of the malpractice.

While establishing there was a relationship that required a duty of care is generally straightforward, defining the standard of care and proving causation can be more complex.

The standard of care due to a patient can vary due to a variety of elements, including:

  • the size and type of medical facility (a teaching hospital would generally be held to a higher standard than a rural community hospital)
  • the availability of resources at a medical facility (specialized diagnostic tests may not be immediately available in all places)
  • the level of experience of staff (a doctor or nurse who is newly certified would be held to a different standard than a practitioner with more experience, and a generalist is held to a different standard than a specialist)

Even if the standard of care is breached, a plaintiff must also prove the breach caused or contributed to damage, and that this damage would not have happened irrespective of the malpractice. For example, if medical practitioner negligence caused an injury that resulted in a patient's death, but the patient's death was already imminent, a claim for medical malpractice would likely be unsuccessful.

Nevertheless, there are many times when malpractice does contribute to a significant loss for a patient or their loved one.

An investigation into unexpectedly poor outcomes can help provide closure for these people by either confirming that medical providers did all they could for a patient, or by discovering that a patient and/or their loved ones deserve compensation for harm that has been done to them. Moreover, there is often comfort in the knowledge that the medical providers will be held accountable and hopefully learn from their tragic errors to prevent other people from experiencing similar outcomes.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.