Signing out AMA is a legal term used in Emergency Departments (and other healthcare areas). It is a paper that the patient signs when they are leaving against medical advice so that the lawyers don’t sue the doctors or facility for letting the patient leave without being properly informed.
For instance, a patient that may be having a heart attack might come to the ED complaining of chest pain, like my patient tonight. If the patient wanted to leave before any testing or a diagnosis is made, I would inform him that he may be having a heart attack, a blood clot in his lungs or other severe intrathoracic event that might be fatal without treatment.
Tonight’s case was standing on the sidewalk by a building not doing nothing. The police arrested him and took him to jail. He told them he was having chest pain and he ended up in my ED. Before I finished saying hello, he wanted his IV out and wanted to leave. The police cited him but didn’t want him back. So he signed out AMA and left the ED.
About 2 hours later we get notified by EMS that they are coming in with a gunshot wound to the chest. It was the same patient. Unfortunately, the GSW was fatal.
Now, the revised AMA instructions for leaving AMA with chest pain include the following.
Death from;
Cardiac ischemia
Pulmonary embolus
Pneumothorax
Gunshot wound
I figure it was another drug deal gone bad. The police unknowingly interrupted him receiving drugs that he didn’t pay for or him delivering drugs that somebody didn’t pay for.
Your grumpy Uncle/Brother Dave
Weary