Question

Please provide citations using APA-style and provide links to resources as well as a bibliography.

a.   Identify the main issue in the case.

i.   Phrase the issue of the case in the form of one or two brief statements.

b.   What are the facts of the case?

i.   These should be summarized in clear, concise, and chronological statements. Only the major facts, important to the issues in the case, should be included.

c.   Were the 2 basic guiding principal obligations of EMTALA breached?

i.   Explain each guiding principal and the required obligation(s) to the patient.

ii.   Apply the facts of the case to the 2 basics guiding principal obligations of EMTALA, and describe in detail how the obligations were upheld or breached.

d.   Assume that the patient has a valid medical malpractice claim. What would the basis of the claim be?i.   What elements must be proven for the patient to prevail on a medical malpractice claim (negligence claim)?

1.   Apply the facts of the case to the elements required for the plaintiff to prevail.

2.   What defense could the defendant(s) have to the plaintiff’s medical malpractice claim?

e.   What penalties may the defendants in the case be subject to if a violation of EMTALA is found?

f.   What damages may be awarded to the patient if she prevails on a medical malpractice claim?

Please consider the following scenario to complete this assignment:

Susan Power was brought by her fiancé to the emergency room at Arlington Hospital on February 24, at approximately 5:45 a.m. At the time, she was 33 years old, unemployed, and had no health insurance. Arlington Hospital is a large 400 bed teaching hospital with the most current and up to date equipment and facilities.

Upon arrival to the emergency department, Power complained of pain in her left hip, lower left abdomen, pain in her back running down her leg, and that she was unable to walk. She was shaking and had severe chills. Power also had a sizeable boil visible on her cheek that she reported she had tried to “pop” earlier that week.

Power was initially taken to a treatment room and seen by a nurse, Barbara Goldy, R.N., who took a brief medical history from her, did a nursing assessment that indicated the patient could not walk, was shaking and felt chilled. Along with the medical information recorded on Power's chart were also the notations that indicated that she was unemployed and uninsured.

Power was next seen by an emergency room physician, Dr. Heiman, who spoke with her, examined her hip, did a motor examination and leg extension test, all of which were within normal limits, and ordered x-rays of her hip. No other tests were ordered.

Another nurse, Christine Stadher, R.N., completed the patient information data and took Power's vital signs, including her blood pressure, all of which were within normal limits. Nurse Stadher, also indicated that Power was complaining of pain in her abdomen and her back that ran down her leg. The boil on Power’s cheek was not documented anywhere in the nursing notes.

Shifts changed at 7:00 a.m., and Dr. Semmes, another emergency room physician, examined Power. Dr. Semmes did not look at the patient intake information, he did look at the x-rays that had been taken but did not record the results of the x-ray on Power's chart. He did record on Power's chart acute left hip pain of unknown etiology. Dr. Semmes performed a neurological examination he documented a normal assessment but did indicate that "she did not look ill in terms of toxic, but she was uncomfortable." He ordered a urinalysis test; he did not order any other diagnostic procedures, including a blood test.

Based on his examination, Dr. Semmes believed that Power's pain was localized and musculoskeletal in nature, and that she did not have an infection and was not ill. The hip x-ray was negative in all respects. Before the results of the urinalysis came back from the lab, Dr. Semmes discharged Power. He gave her a prescription for anti-inflammatory and pain medications and instructed her to avoid bearing weight on her left leg. Dr. Semmes also told Power that if her pain persisted or became worse, she should return to the emergency room or call the orthopedic surgeon whose name, address, and phone number he had given to her in her discharge paperwork.

After Power was discharged, Dr. Semmes, told the charge nurse that he probably would have ordered some more tests to see if there was something else going on but he knew there was no way she would ever pay for any of it since she was unemployed and didn’t have insurance. When her pain worsened, Power returned to the Arlington Hospital emergency room at approximately 10:15 p.m. on the following day, February 25^th.

She presented with the same symptoms as the day before except that by this time she was in a very unstable condition with a very low blood pressure and elevated heart rate. Her vital signs signified that she was in severe shock, which the doctors believed was probably septic in nature, and she was admitted to the intensive care unit at Arlington Hospital at approximately 1:00 a.m.

An orthopedic surgeon concluded that the hip pain was not the source of Power's problems. The hospitalist in consultation with an infectious disease specialist, decided to treat her with antibiotics pending the results of a blood culture. The ultimate etiology of Power's illness was that she had "seeded" an infection in her blood approximately 10 days earlier when she had attempted to lance the boil on her face.

Power was in critical condition for the first several months of her hospitalization. Because of her level of shock, the medications required to control her infection and maintain her blood pressure, and the circulatory problems caused by these medications, Power had to have both legs amputated below the knee. She also lost sight in one eye and developed severe and permanent lung damage. By mid-April, Power's status was no longer critical.

On July 1^st, Power was transferred to a rehab facility where she stayed as an inpatient for 6 months while recovering her strength and learning to walk with the use of prosthetics. She is unable to do any physical activity without supplemental oxygen because of her lung damage.

Answer 1

A,i, Patient came with the complaints but due to she is unemployed and uninsured Physician didn't diagnosed her condition well with proper investigation..In later it made her to have septic shock, amputation, lung damage,she lost her eye sight..

B, i, Dr. Semmelwies,thought that there would be something problem in her body but he didn't screened her well..this is only due to unemployment and she can not pay the bill for the treatment due to uninsured....but real fact of power case she had severe infection inside her body it made her to get septic shock..infection spread all around her body it made her severe loss of her body parts..

C,I, EMTALA( emergency medical treatment and labour act).. federal law requires hospital emergency department to medically screen all the patient who seek emergency care ,regardless of health insurance status or ability to pay..

ii, in this case this hospital didn't followed the EMTALA law due to power unemployment,uninsured and she would not able to pay her medical bill..they diagnosed her with out current treatment and screening.

D, i, power sickness happened due to negligence act or omission,it causes severe physical injury..now malpractice claim power has the right to apply health care professional standard negligence case..she has the proof of old prescription with date and time she can apply as a case against the Physician..

Ii, The plaintiff's must be legal, montage,or other negative ramifications caused by the negligence..there should be direct link between a violation of the standard of professional conduct and the negative results..power has a valuable reason of her health outcome with disabled she losses far in excess of the amount of legal fees and expenses necessary to bring the action..