Areas of Expertise
Dr. Wickline provides expert analysis and testimony across the full spectrum of emergency medicine cases. Actively practicing at trauma, urban and rural hospitals, he understands how the standard of care applies in varied clinical environments.
Stroke
Stroke is one of the most frequently litigated conditions in emergency medicine. Cases typically involve allegations of delayed recognition, failure to activate a stroke alert, or missed opportunities to administer thrombolytics within the treatment window.
Dr. Wickline evaluates whether the emergency physician's assessment, imaging, and treatment timeline met accepted standards given the patient's presentation and the facility's stroke capabilities. Key issues include the adequacy of the neurological exam, appropriateness of the differential diagnosis, timeliness of CT imaging, and documentation of the decision-making process around thrombolytic eligibility.
Sepsis
Sepsis cases center on whether the emergency physician recognized the condition in a timely manner and initiated appropriate resuscitation. The Surviving Sepsis Campaign's Hour-1 bundle calls for blood cultures, lactate measurement, broad-spectrum antibiotics, and IV fluid administration within one hour of sepsis recognition. Research consistently shows that each hour of delay in antibiotic administration increases mortality.
Dr. Wickline analyzes the clinical timeline from triage through disposition, evaluating whether vital sign trends and lab results were acted on appropriately. Common issues include failure to recognize sepsis in patients with atypical presentations, inadequate fluid resuscitation, delayed antibiotic administration, and insufficient reassessment after initial treatment.
Cardiac Emergencies
Cardiac cases in emergency medicine litigation frequently involve STEMI identification, acute coronary syndrome evaluation, and cardiac arrest management. National quality standards target a door-to-balloon time of 90 minutes or less for STEMI, and the emergency physician's role in obtaining, interpreting, and acting on the initial ECG is central to most cases.
Dr. Wickline reviews ECG interpretation accuracy, timeliness of cath lab activation, appropriateness of anti-ischemic therapy, and ACLS protocol compliance during cardiac arrest resuscitation. He also evaluates cases involving atypical chest pain presentations, risk stratification decisions, and the adequacy of workups for patients discharged from the ED with cardiac complaints.
Trauma
Trauma cases require evaluation of the emergency physician's adherence to ATLS protocols, triage decision-making, and stabilization priorities. Cases may involve blunt or penetrating trauma, missed injuries on secondary survey, delayed recognition of internal hemorrhage, or inadequate monitoring during the resuscitation phase.
Dr. Wickline assesses whether the trauma evaluation was systematic, whether imaging and interventions were appropriately prioritized, and whether transfer decisions complied with EMTALA requirements. His experience across both trauma centers and community hospitals allows him to evaluate care in the context of the specific resources available at the facility where treatment occurred.
Additional Areas
Beyond these core areas, Dr. Wickline provides expert analysis in cases involving:
- Airway management — intubation decisions, failed airway protocols, and sedation complications
- Abdominal emergencies — appendicitis, aortic aneurysm, bowel obstruction, and ectopic pregnancy
- Neurological emergencies — meningitis, subarachnoid hemorrhage, and spinal cord compression
- Disposition and handoff — discharge decision-making, admission criteria, and communication failures during transitions of care
- ED operations — overcrowding, boarding, staffing adequacy, and systems-level failures
Representative Experience
Below are anonymized summaries of the types of cases Dr. Wickline has worked on as an expert. No client names, outcomes, or identifying details are included.
- Retained by plaintiff in a missed pulmonary embolism case involving alleged failure to risk-stratify and obtain contrasted CT pulmonary angiography in an emergency department patient with dyspnea. Provided deposition testimony.
- Retained by defense in a delayed stroke diagnosis case involving atypical presentation of CVA. Provided deposition testimony.
- Retained by defense in a delayed diagnosis of cerebral venous sinus thrombosis (CVST) involving atypical neurologic symptoms and the decision to obtain advanced neuroimaging. Provided deposition testimony.
- Retained by plaintiff to review records in a delayed diagnosis of Fournier’s gangrene involving assessment of a patient presenting with perineal pain and early soft tissue infection signs.
Last updated: April 2026
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