The Charted Defense
The Charted Defense Podcast
Welcome to The Charted Defense Podcast — where medicine meets the law.
I’m Michael Coleman, MD, a practicing physician and hospital medicine leader, sharing practical lessons from real-world malpractice themes, sepsis workflow failures, abnormal-result follow-up misses, and documentation breakdowns that put patients and clinicians at risk.
Each episode turns complex medical-legal issues into clear, actionable takeaways for physicians, advanced practice clinicians, and healthcare leaders. You’ll hear case-based analysis, system-level risk management strategies, and communication frameworks you can apply immediately in clinical practice.
If you care about safer care, cleaner documentation, and reducing preventable legal exposure, this show is for you.
What you can expect
- Medical malpractice case breakdowns in plain language
- Clinical communication and handoff failure analysis
- Documentation and follow-up systems that hold up under scrutiny
- Practical physician checklists for day-to-day risk reduction
Disclaimer: This podcast is for education and commentary only. It is not medical or legal advice and does not create a physician-patient or attorney-client relationship.
Episodes
37 episodes
No Note, No Defense | Case 8
A college student walks into a community emergency department after a reported fall. The CT shows bilateral frontal hemorrhages. A neurosurgeon directs her care by phone from home — orders are placed, but no narrative note explains the re...
The Closing Window: The Trial and the Lessons | Case 7 Episode 2
The trial, the verdict, and the lessons. A six-person jury, a two-week trial, a defense verdict on every count, and an appeal that is now pending. How the plaintiff turned vocabulary differences across providers into an argument. How the...
The Closing Window: The Patient's Story | Case 7 Episode 1
A taxi driver finishes his overnight shift and feels something change. He arrives at a major urban emergency department within minutes of the symptoms beginning. Stroke alert is called. CT is clear. The team offers the clot-dissolving med...
Nine Decision Points | Case 6 episode 3
The teaching episode. Nine specific moments across this case where a different decision could have changed the outcome — from the PCP's office to the ED triage to the radiologist's read. Each one a small choice. Each one part of a chain. ...
Page 334 | On The Record | Case 6 Episode 2
The deposition story. A single page of the medical record — the page the plaintiff's attorney returned to again and again — became the load-bearing document of the case. How a routine triage note became the moment the case turned. The tri...
Two Hours - Case 6 | Episode 1
A 70-year-old man develops dizziness and difficulty walking. He sees his primary care physician. He's sent to the emergency department. Two hours pass between when the symptoms began and when stroke is finally on the differential. By the...
Inherent Function
The legal doctrine that decided this case. When a hospital contracts out its emergency department, can it still be liable for the contractor's care? This episode walks through the appellate ruling — and the documentation lessons every hospitali...
What the Chart Couldn't Defend
The trial story. How a chart built across three encounters by three different emergency physicians becomes plaintiff's exhibit, deposition by deposition. The notes that were thorough. The notes that weren't. The handoff that didn't happe...
Three Visits: The Patient's Story
A previously healthy adult traveler presents to a community emergency department with cough, sore throat, headache, and a tight neck. She returns the next morning, and again that same night. Each visit, the clinical picture sharpens. Eac...
The Exam You Can't Trust
A patient presents with fever, headache, and neck stiffness. The physician diagnoses viral syndrome and does not perform a lumbar puncture. The patient deteriorates rapidly. Explores the anchoring bias and availability heuristic that drive diag...
The Back Pain You Cannot Afford to Miss
A patient with IV drug use history presents with back pain and fever. The treating physician diagnoses musculoskeletal pain without pursuing emergent spinal imaging. The epidural abscess compresses the spinal cord, and by the time surgical deco...
The Eleven-Second Attestation — When a Stroke Looks Like a Migraine and the Chart Tells the Whole Story
A retired chiropractor in his sixties pulls off a rural Southern highway with sudden neck pain, dizziness, nausea, vomiting, and numbness on one side. He's brought to a community ED, triaged as a mid-acuity patient, and worked up by a nurse pra...
Case 4 Episode 3 | The Experts
Inside the expert witness testimony and trial strategy. An EM physician from a major university who participates in international CPR guideline development. Covers reptile theory, an EMTALA question resolved in chambers, and the jury's verdict....
Drug-Seeking | Cognitive Autopsy Case 5
A middle-aged patient with a history of injection drug use and frequent ED visits arrives complaining of acute leg pain. The provider has seen this patient before. The chart already labels her. The exam is brief — and what is documented ...
The Eleven-Second Attestation — When a Stroke Looks Like a Migraine and the Chart Tells the Whole Story
A retired chiropractor in his sixties pulls off a rural Southern highway with sudden neck pain, dizziness, nausea, vomiting, and numbness on one side. He's brought to a community ED, triaged as a mid-acuity patient, and worked up by a nurse pra...
The Lawsuit
From bedside to courtroom. The complaint, discovery battles, expert testimony, and the hospital's defense that care met the standard — how a patient's death becomes a legal case.
The Template Will Get You — When "Neurological Exam Intact" Is a Click, Not a Conclusion
You open the chart. The template loads. The neurological exam section already reads "intact." You sign the note and move on. Eighteen months later, a plaintiff's attorney has your note side by side with a physical therapist's, a nurse's, and a ...
Case 4 Episode 1 | The Patient
A middle aged man calls 911 with chest pain early one morning. This season traces the alleged cascading failures — STEMI transfer delay, helicopter vs. ground transport decision-making, airway cascade failure in the cath lab. This case led to a...
The Outpatient MRI Trap
A patient walks into a Georgia emergency department with back pain and red-flag neurologic symptoms. Cauda equina syndrome is on the differential — but instead of an emergent MRI, the workup gets punted to the outpatient setting. By the time im...
The Cell Tower Ping and Your Defense
Your phone, your EHR, and your badge are all keeping records you never think about. In this episode, we break down how digital evidence — from cell tower pings to audit trails — is quietly becoming the most powerful tool in malpractice litigati...
The Ankle Reflex Trap — When Experience Becomes the Enemy
A hospitalist checks ankle reflexes on a patient with severe back pain. They're intact. The brain says cauda equina syndrome is unlikely. But intact reflexes have no validated role in ruling it out — and that single reassuring finding becomes t...
The Shield That Keeps Growing — Mississippi's COVID Immunity and the Diagnostic Delay That Can't Be Sued
A patient recovers from COVID-19 in early 2021. Weeks later, he begins losing strength in both legs. Then he can't urinate. He goes to a hospital, then a clinic, then another provider. For three months, no one connects the dots. When the diagno...
The Asymmetrical Shield: How Section 6(b) Changes Your Defense Strategy
The American Law Institute rewrote the rules for medical malpractice — and buried inside the 2024 Restatement is a provision most physicians have never heard of. Section 6(b) creates a one-directional shield: evidence-based practice can defend ...
Medical Malpractice Stress Syndrome: Part 3
Part 3 — "Before You Get Sued" — Prevention, preparation, and peer support interventions. The proactive episode — what physicians can do now (before they're ever named in a suit) to build resilience, understand their malpractice policy, ...
The First Label — How Triage Notes Anchor the Differential and Derail the Diagnosis
A 2023 JAMA Internal Medicine study looked at more than 108,000 emergency department visits across 104 VA facilities and asked one simple question: does the wording in a triage note change how physicians work up a patient? The answer was unambi...