Mr B was a 46-year-old nurse practitioner working in the busy emergency department (ED) of a hospital. He had been working in the ED for more than a decade, and he was used to the fast-paced environment and the need to triage and assess patients quickly and accurately. Some shifts were worse than others.

One weekend, Mr B was stuck doing a Saturday night shift, which was one of the worst in his opinion. The ED was crammed with patients in varying degrees of distress, waiting to be seen. Mr B and the rest of the ED staff were working as fast as possible to make sure that all the patients were treated.

One of the patients in the ED that night was Mrs P, aged 63 years. She was initially assessed by one of the triage nurses who told Mr B that the patient came in complaining of a burned mouth and throat, but upon examination, only had a sore throat that appeared mildly red.

“But she’s saying that her mouth and throat were horribly burned by some unidentified perpetrator and she wants us to report her injuries,” said the nurse, shaking her head. “She’s saying she wants to see a specialist, but I don’t see anything wrong with her other than the sore throat. I think she’s a little… off.”

Mr B thanked the triage nurse, and he began taking care of the patients with more urgent needs. Several hours later, the patient, Mrs P, was ushered into the examination room. She immediately began a litany of complaints.

“Why was I sitting here for so long? It’s been four hours! My mouth is on fire! My pain is a 9 out of 10! Where is the doctor?” the patient complained.

Mr B introduced himself and told her that he would be treating her that evening. She immediately insisted that she wanted to be seen by a specialist.

“Why don’t I just take a look first,” Mr B said calmly. Upon examination, the patient’s throat was slightly red. She had no other obvious symptoms.

“It looks like you have a bit of a sore throat,” Mr B said. “I can give you a prescription for something to gargle with that will make it feel better.”

“I don’t want a prescription,” the patient said angrily, “I want to see a specialist. I want someone to look at the burns in my mouth! And I want you to report the burns to the authorities!”

“I’m sorry,” Mr B said as soothingly as he could, “A specialist is not required here, and I see no burns in your mouth.”

The patient jumped up, furious, and said, “if THIS is how you’re going to treat my serious problems, then forget it.” She ran out of the examination room and left the ED. Mr B shook his head, but he did not have time to worry about it — there were still many patients waiting.

Mr B did not think about the patient again, until he was notified that he and the hospital were being sued in Federal Court.