Question

) Dr. Contadina is a primary care physician in a Metropolitan area at a large, not-for-profit, integrated health care system. On average, she sees several patients a day from a variety of backgrounds who come in with an assortment of conditions, injuries, and ailments. 
 One day, a patient comes to see her complaining of ankle pain on his right leg. The patient is a farmer and says that he fell while he was taking care of his chickens in the chicken coup. He has some cuts and bruises on either leg, complains of a swollen right ankle, but appears to be fine otherwise. Dr. Contadina instructs him to purchase an air cast at a pharmacy along with some ibuprofen and to take it easy. Dr. Contadina returns to seeing other patients and Joe goes home. 
 Three days later Joe is admitted to the emergency room. He has low blood pressure, a fever, extreme shaking, an irregular heartbeat, and is very agitated. After removal of the air cast, the nurses notice a cut that has become infected on his left leg (the opposite of the leg with the swollen ankle). Joe’s condition continues to worsen and he eventually goes into Septic shock. After two days in the ICU, Joe dies of complete organ failure. 
 The family wants answers, and so far all they know is that he came in with one small cut and suddenly died. The hospital is pressuring Dr. Contadina to apologize in hopes of mitigating some legal trouble. Dr. Contadina is afraid that if she admits that there was any chance she made a mistake, that she’ll be in bigger trouble- both legally and professionally. She is very afraid of what her colleagues and patients will think if she admits that she made an error. 
 Questions for discussion
 As the administrator of the hospital, what do you do? Do you require that Dr. Contadina apologize to the patient’s family and explain to them what went wrong? What are the risks to doing so? Does Dr. Contadina have an ethical obligation to admit error? What are the possible benefits to admitting fault? What could the hospital and/or Dr. Contadina (or any physician) have done differently? Was this a preventable mistake?


Answer 1

As an administrator it is the legal responsibility to take action on the doctor to suspend or hold the license temporarily

Every patient and relatives deserves the legal and ethical rights to get to know the line of treatment and its effect. The doctor is supposed to give a brief explanation on the incident to the relatives and sincerely apologize

The main risk is to

• loose the practicing license or suspension or a probationary period
• Defame of the name and reputation of the doctor as well as the hospital
• Patients can loose hope on the healthcare team

Dr.Contains have an ethical obligations to admit error because it seems to be medical negligence of making the patient themselves to put a cast and tank some pain killer.In these cases it is a must for a Dr. observation when these type of procedure is done.

When the error is admitted the Dr can be warned and given a memo and oractuce in a probationary period for time being

The hospital should have made a policy ,protocol on the patients who come for emergency care to be examined completed assessed for risk and then provided treatment.Dr.Contadina should have examined th patient thpurougly and applied the air cast by a medical professional to avoid any mistakes and could have been prevented in this way.