Current risk landscape of point-of-care ultrasound in pediatric emergency medicine in medical malpractice litigation

Background: Point-of-care ultrasound (PoCUS) is expanding as a diagnostic tool in pediatric emergency medicine. Pediatricians are apprehensive to take on the risk of malpractice from incorrect interpretation of PoCUS imaging, therefore limiting its use. Although current studies provide reassurance to this concern, none look directly at the risk for pediatric emergency medicine physicians. Our study aims to evaluate the current medicolegal risk landscape posed by PoCUS in pediatric emergency medicine. Methods: A search of case law was performed utilizing the LexisNexis caselaw database for the period of January 2011 through December 2021. Initial search results were reviewed by the attorney co-authors for relevance to medical malpractice surrounding PoCUS. The remaining cases were reviewed by physician co-authors to ensure their relevance to both ultrasound and the acute care setting. Identified cases were then classified into categories as per the reason for the claim. Results: No cases of malpractice litigation were identified that directly related to PoCUS. Ten cases of ultrasound in the acute care setting were identified, 7 of which were in pediatric patients. The majority of these cases related to appendicitis or testicular torsion. Of these 10 cases, 2 cases claimed failure to consider the ultimate diagnosis, but ultrasound would have been an appropriate study had the diagnosis been considered. Of the 8 remaining cases, 6 were based on failure to perform or delay performing ultrasound, 1 claimed that improper ultrasound study was initially performed, and 1 case was based on an improper diagnosis made by ultrasound. Discussion: PoCUS does not appear to pose a significant risk of malpractice litigation in pediatric emergency medicine.