When the Handoff Fails: Forensic Analysis of Transition-Point Liability in New York Emergency Psychiatry

Stephan M. Carlson, MD, MBA, FAPA · Psychiatric Malpractice

A psychiatric patient passes through many hands in an emergency episode—triage nurse, emergency physician, crisis clinician, admitting psychiatrist, covering resident, discharging social worker. When the outcome is bad, both sides reach for the handoff. The forensic task is to decide whether information was actually lost at a transition, whether that loss was a departure, and whether a faithful handoff would have changed the decision that followed. The transition is where liability concentrates Emergency psychiatry is structured as a relay. A patient may move from emergency department triage to a Comprehensive Psychiatric Emergency Program, from the emergency program to an inpatient unit, or

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