Question

Think of yourself as both a nurse and lawyer whose job it is to provide the CEO an understanding of the legal issues arising from the care of a hospitalized patient. When presenting a legal case to the CEO you will want to provide a thorough yet brief understanding of the facts, potential legal issues including potential parties to the case, breaches of standard of care, any potential available defenses, and potential monetary damages.

Case for this assignment:

On October 3rd Mr. Todd a 60 year old corporate executive and otherwise healthy adult was admitted to Rapides General Hospital for chest pain. The next day on October 4th, Dr. Sauls, a cardio thoracic surgeon, performed bypass surgery. During the following days, Todd did not ambulate well and suffered a weight loss of 19.5 lbs.

On October 17th, the medical record indicates that Mr. Todd’s sternotomy wound and the midlower left leg incision were reddened, and his temperature was 99.6 F. There was not any indication in the medical record that Sauls was contacted with this information by the nursing staff. Sauls did not routinely read the nursing notes but instead preferred to rely on his own observations of the patient. In his October 18th notes, he indicated that there was no drainage or redness to the surgical site. However, the nurses’ notes indicate redness and drainage at the chest tube site with a temperature of 101.2 F. Sauls’ notes indicated the patient was afebrile.

On October 19th, Sauls’ notes indicate that Todd’s wounds were improving and he did not have a fever. Nurses’ notes indicated redness and drainage at the surgical wound sites, a temperature of 100 F, and notification to Sauls by the bedside nurse informing him of the patient’s current condition. No new orders were received from Sauls in response to nurse’s notification.

On October 20th, nurses’ notes continue to indicate surgical site redness, drainage and febrile temperature. No wound culture had been ordered at this point. Dr. Kamil, one of Todd’s treating physicians, noted that Todd’s nutritional status needed to be seriously looked into and suggested that Sauls consider supplemental feeding. Despite this, no follow-up to his recommendation appears, and the record is void of any action Sauls took to obtain a nutritional consult.

On October 21st, Todd was transferred to the Intensive Care Unit because he was gravely ill. The nurses’ notes for the following day of October 22nd describe the chest tube site as draining fouls-melling bloody purulence. Todd’s temperature was recorded to have reached 100.6 F. This is the first time that Sauls ordered the chest tube site cultured. On October 23rd, the culture report indicted a staph infection, and Todd was started on antibiotics to treat the infection.

On October 25th, at the request of Todd’s family he was transferred to St. Luke’s Hospital. At St. Luke’s, Dr. Leatherman, an internist and invasive cardiologist, treated Todd. Dr. Zeluff, an infectious disease specialist, examined Todd’s surgical wounds and prescribed antibiotic treatment. Upon admission to St. Luke’s, every one of Todd’s surgical wounds was infected. Despite the care given at St. Luke’s, Todd died on November 2nd.

Instructions for this homework assingment:

a. Identify the main issue in the case: Phrase the main issues of the case in the form of one or two brief statements. (e.g., the issue is whether or not the patient’s injuries were caused by a failure to provide the appropriate standard of care required for the treatment of infections.)

b. What are the facts of the case? These should be summarized in a clear, concise and chronological order. Only the major facts, important to the issues in the case, should be included.

c. Are all the elements required in a negligence suit present? List the required elements for a negligence suit. Explain each element. Apply any facts from the case to the element it would be associated with.

d. Who would you consider to be the potential plaintiff and defendant?

e. How would you argue for the plaintiff? What evidence would you present?

f. How would you defend the defendant? What are your defense options?

5. In your opinion, what would be the likely outcome if the case was to go to court?

6. If the defendant was found negligent, what damages could be awarded and why?

Answer 1

• Its a case of negligence from health care team. Both doctor and nurses are responsible for this
• After the surgery todd did not ambulate well and there was a weight loss. In this scenario, the duty of the nurse is to check the patients chart for any order of ambulation post operatively. If not, the nurse can question the doctor, if the patient requires ambulation for better health. Another concern is , does the nurses report the doctor regarding the weight loss. If doctor does not care about this, nurses have the right to question the doctor because client is the most important person during the care.
• Why nurses did not contact the doctor, when there is an elevated temperature, if contacted, why there is no documentation. Infact, documentation is very important during care of the patient
• A registered nurse can question a doctor, if the patient is not getting antibiotics to control the fever or if the doctor rely on his observations, it is the duty of the nurse to explain about the current scenario of the patient with respect to the nursing notes from the past.If a registered nurse is not happy with the surgeons order, she can approach to the head nurse or else she can call to the physicians regarding the current scenario of the patient because client is the most important factor.
• If the concerned doctor does not care about the patients ill, a registered nurse can approach the Nursing Manager.
• Date or Documents are very important while the case goes to the court
• In my opinion, it is a pure case of negligence from health care team and the defendant will lose it
• If the defendant was found negligent, his licence would be cancelled from the authorities.