Malpractice Litigation and ER Documentation: Spotting Claims, Identifying Exposure, Assessing Liability

Mary A. Azzarito | Adler, Cohen, Harvey, Wakeman and Guekguezian, L.L.P

Mary M. Azzarito is a partner at Adler, Cohen, Harvey, Wakeman & Guekguezian, LLP in Boston, with more than 30 years of experience defending physicians, hospitals, and healthcare providers in complex medical malpractice and professional liability cases. She has tried and won high-stakes jury trials involving emergency medicine, obstetrics, cardiology, and pediatrics, and was counsel in the first Massachusetts hearing applying the Daubert/Lanigan standard for expert testimony. Ms. Azzarito’s work emphasizes the critical role of accurate documentation and electronic medical record (EMR) management in emergency-room litigation, and she regularly advises on strategies to strengthen recordkeeping practices, reduce exposure, and defend against allegations of negligence or record deficiencies. Her combination of courtroom experience and regulatory insight, particularly before the Massachusetts Board of Registration in Medicine, makes her a leading authority on the intersection of ER operations, medical records, and malpractice defense.

Kenny Stein | Kenneth A. Stein, MD

Kenneth A. Stein, MD, is board-certified in both Emergency Medicine and Internal Medicine and specialty-certified in Neurocritical Care. Dr. Stein has practiced Emergency Medicine and Critical Care Medicine for 27 years.

As an expert witness for both plaintiff and defense, Dr Stein has reviewed over 700 cases and has testified 300 times in cases related to emergency medicine, critical care, internal medicine, and personal injury. Dr Stein clearly explains completed medical situations, so they are understood by judges and juries.

Sara Bazzigaluppi | Chapman Law Group

Sara Bazzigaluppi is Chairperson of the Florida Professional Licensing and Regulatory Affairs division at Chapman Law Group. Based in the firm’s Sarasota office, she has represented healthcare professionals and regulated healthcare businesses for more than 10 years across the country in complex licensure, regulatory, and compliance matters.

Sara advocates for a wide range of healthcare professionals including individual providers such as physicians, pharmacists, nurses, and mental health practitioners, and business entities, including pain management clinics, dental offices, optometry practices, laboratories, urgent care clinics and more. She is widely regarded for her work in defending clients against investigations, administrative complaints, and emergency suspensions, before the Florida Department of Health (FLDOH), and matters involving the Agency for Health Care Administration (AHCA), Office of Inspector General (OIG), and the National Practitioner Data Bank (NPDB).

Her practice also includes credentialing and peer review disputes, licensure applications involving criminal or disciplinary history, and disciplinary actions brought by national certification boards. In addition, she provides contract and compliance guidance on employment agreements, business associate agreements, provider and supervisor agreements, and frequently intervenes in pre-litigation settlement negotiations.

In addition to her practice, Sara has led multiple educational seminars for attorneys and healthcare professionals, providing practical guidance on risk management, regulatory oversight, and compliance strategies tailored to the healthcare sector. This includes presentations before the Florida Bar Health Care Law Division, the Florida Medical Association and the Home Care Association of Florida.

Prior to joining Chapman Law Group, Sara clerked for a large hospital system where she worked closely with General Counsel and Risk Management to address legal issues. She drafted ethics policies and procedures for more than 20 hospitals within the healthcare system.

Session I – Medical Malpractice Defense and Emergency Room Records: What Attorneys Need to Know | 1:00pm – 2:00pm

• Emergency department documentation & litigation risks
  • Chronology of ED visits, physician notes, and records from other providers
  • Issues with communication, EMR use, and pitfalls like text messages or copy-paste practices
• Accuracy, follow-Up, and liability Exposure
  • Importance of documenting medical decision-making, disposition decisions, AMA discharges, and follow-up on lab/radiology results
  • Case examples highlighting exposure risks and incidental findings
• Evidence & trends in EMR practices
  • Audit trails, late entries, and attestations as evidence
  • Embedded warnings, evidence-based recommendations, and how to evaluate ED records for malpractice defense

Break | 2:00pm – 2:10pm

Session II – EMTALA Compliance, CMS Standards, and Hospital Risk Management: The Role of Record-Keeping | 2:10pm – 3:10pm

• EMTALA
  • Core requirements
  • Enforcement & penalties
  • Legal insights
• CMS (CoPs)
  • Regulatory purpose: Minimum safety and quality standards for Medicare/Medicaid participation
  • Key ED-related cops
• Hospital risk management concerns
  • Administrator goals
  • Risk hotspots
• Record-keeping & discovery
  • Electronic Medical Records (EMRs)
  • Discovery strategy
• Practical guidance for physicians and hospitals