2011 TMLT Memorial ScholarshipInstructionsThe TMLT Memorial Scholarships recognize Texas medical students who are interested in findingcreative and effective ways to enhance patient safety. TMLT will award four $10,000 scholarships inSeptember 2011.To be eligible for the scholarship, applicants must:• be entering their second, third, or fourth year at a Texas medical school in the fall of 2011;• be in good academic standing;• be able to demonstrate financial need;• be able to communicate a commitment to patient safety through an essay; and• be a current student member of, or have a student application pending with, the Texas MedicalAssociation.Applicants who do not meet these criteria will not be considered. Please review the TMLT MemorialScholarship Rules and Regulations.To apply, please submit the following:• a completed and signed application (incomplete or unsigned applications will not be considered);• an official medical school transcript; and• a short essay of no more than 500 words describing the risk management considerations for aclosed claim study provided with this application. The essay should be typed (double-spaced) ona separate sheet of paper. Be sure to include your name on your essay. Entries will be judged andwinners selected by the TMLT Board of Governors.Deadline for all materials is June 3, 2011. Materials must be sent via U.S. mail, UPS, or FederalExpress. Any entry postmarked after June 3, 2011 will not be considered. We will acknowledge receiptof your application materials by email, if an email address is provided.Please return all application materials to:TMLTAttn: William MalamonPO Box 160140Austin, TX 78716Physical address (for applications sent via Federal Express or UPS):TMLTAttn: William Malamon901 S. Mopac Expressway, Barton Oaks Plaza, Bldg V, Ste 500Austin, TX 78746Questions? Please contact William Malamon at 800-580-8658 ext. 5898 or firstname.lastname@example.org.
2011 TMLT Memorial ScholarshipRules and regulations1. Governing board members, employees, and vendors of Texas Medical Liability Trust, itssubsidiaries and their immediate families (parents and children) and households (those residingat the same address or dwelling) are not eligible for the scholarship.2. Entry constitutes permission to use winner’s name, essay, and likeness for the purposes ofadvertising, promotion, and publicity without additional compensation.3. All entries become the exclusive property of Texas Medical Liability Trust.4. Entries that do not comply with the rules will not be considered.5. All sections of the application must be completed. Incomplete applications will not beconsidered.6. All federal, state, and local laws apply.7. Taxes are the responsibility of the winner.8. Scholarship winners will receive scholarship funds upon confirmation of enrollment. Paymentwill be made through the university/college financial aid office.9. No prize substitutes, no cash in lieu of scholarships. The scholarship is non-transferable.10. Winners will be chosen in a competitive process based on a point system that weighs eachstudent’s financial need and essay. Judges’ decisions are final.
2011 TMLT Memorial ScholarshipApplicationThis application is formatted as a fillable PDF file. You may type your information directly into thePDF, but then you must print and sign the application. Please complete the entire application.Incomplete or unsigned applications will not be considered.Name _______________________________________________________________________Address _____________________________________________________________________Phone ______________________________________________________________________Email _______________________________________________________________________1. In the fall of 2011, I will be a second-year third-year fourth-year student at: (check one)Baylor College of MedicineTexas A&M Health Science Center College of MedicineTexas Tech University Health Sciences Center School of MedicineUniversity of North Texas Health Science Center’s Texas College of Osteopathic MedicineUniversity of Texas Medical School at San AntonioUniversity of Texas Medical Branch at GalvestonUniversity of Texas Medical School at HoustonUniversity of Texas Southwestern Medical SchoolTexas Tech University Health Sciences Center School of Medicine Paul L. Foster School ofMedicine2. Where did you complete your undergraduate education?____________________________________________________________________________________________________________________________________________________________3. Degree(s) received______________________________________________________________________________
4. How have you paid for medical school (list percentages totaling 100 percent)?________________ self-employment________________ family________________ spouse________________ scholarships or grants________________ student loans________________ other (please specify)5. Are you a student member of the Texas Medical Association (TMA)? Yes No6. If no, since membership in TMA is a requirement for eligibility, is your membership pending? Yes No(There is no charge to become a student member of TMA. You can apply online at www.texmed.org.)By my signature below I certify that all the information I have provided on this application is true andcorrect. I further certify that I have read and will comply with the scholarship rules and regulations. Thissection must be completed.___________________________________________________signature_______________________date
Statement of financial needDiscuss any factors that affect your financial aid or ability to pay for medical school. Consider includingthe following information in this statement: number of dependents, anticipated debt level upongraduation, and employment history (if any) while attending medical school. This section must becompleted.
EssayPlease read the following TMLT closed claim study. In 500 words or less, discuss the “risk managementconsiderations” of this case. Specifically, what actions or inactions of the physician or physicians led tothe allegations of medical malpractice, and what techniques may have either prevented the outcome orincreased defensibility. Essentially — if you were a physician in this case, what would you have donedifferently and why?Please keep in mind that this closed claim study is based on an actual malpractice claim filed against aphysician covered by TMLT. The identifying information has been changed, but the clinical details ofthe case have not.Please print out your essay and submit it with your application.Failure to diagnose myocardial ischemiaPresentationA 45-year-old man went to the emergency department (ED) of a community hospital complaining ofinfrequent chest pain. He had a history of anxiety disorder, depression, high blood pressure, coronaryartery disease, and a family history of heart disease. He reported smoking a pack of cigarettes a day for20 years.The patient was seen by the on-call hospital family physician.Physician actionOnce in the ED, the patient reported that his chest pain had stopped. The pain had started the previousevening and was located in the middle of his chest. The family physician examined the patient and notedthat his lungs were clear and his heart had a regular rate and rhythm. His blood pressure was 176/92mm Hg and movement exacerbated the patient’s chest pain.The physician ordered an EKG, which revealed nonspecific inverted t-waves with some premature atrialcontractions. He diagnosed chest pain related to bronchitis and prescribed a dose of 1 mg of clonidine tobe administered orally and 500 mg of cefprozil twice a day for 7 days. The family physician thendischarged the patient.Three days later, the patient presented to the same ED complaining of severe chest pain, which hadoccurred intermittently for the previous three days. He was diagnosed with myocardial infarction andcongestive heart failure. He was transferred to a tertiary care facility where he ultimately underwent atwo-vessel bypass surgery. He was hospitalized for 16 days. At discharge, his diagnosis was triplecoronary artery disease with acute myocardial infarction.Two days later the patient was readmitted to the tertiary care facility to treat congestive heart failure.Two cardiologists saw him and consulted with a thoracic surgeon, who felt that the patient was not acandidate for another surgery and that he may eventually need a heart transplant.Allegations
A lawsuit was filed against the family physician, alleging failure to perform the proper tests; failure toadmit the patient for observation; failure to transfer the patient to a facility that could perform anemergency revascularization for myocardial ischemia; and failure to refer the patient to a cardiologist.Legal ImplicationsThe plaintiffs argued that the family physician deviated from the standard of care by not ordering serialtwelve-lead EKGs, a serial cardiac enzyme test, or a chest x-ray. The plaintiffs were also critical that thephysician did not complete a serial examination, and that he did not properly document the patient’sfamily history or the severity of his pain.The defense alleged that the patient’s smoking habit could have led to his condition. They defended thephysician’s exam, saying that it was thorough and did not reveal evidence of myocardial ischemia. Thedefense also pointed out that the physician ordered an EKG, which revealed nonspecific findings, andthat he advised the patient to follow up with his family physician. The defense supported thephysician’s bronchitis diagnosis, stating that it would have been a common condition for a chronicsmoker.DispositionTwo out of three consultants felt the physician breached the standard of care when treating this patient.Therefore, this case was settled on behalf of the family physician.Risk Management Considerations