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

a) The main issue in Todd's case is that he was not been diagnosed with the condition and the indication for performing CABG was not explained by the doctor. The proper collaboration among health care workers were lagging whereby the nurses failed to report the condition of patient orally. The assessment and evaluation of the doctor on the wound was not appropriate.

b) The facts of the case are as follows

#23days of hospitalisation and death of an healthy adult who visited the hospital for chest pain.

# not appropriately diagnosed and planned the surgery

# proper post operative care such as early ambulation and mobility was not initiated

# wound assessment was not done properly which lead the patient to have severe type of infection.

# neglect from the health care team

# death due to inappropriate care.

C) yes all the points that suits negligence is being present. The elements are as follows :

#Duty of care: The health care team has the duty to treat its patients in a medically appropriate manner. Here the care to Todd was not given honestly by the staffs.

#Breach: Here the person will fail to exercise reasonanle care in the fulfillment of the duty. In Todd's case proper diagnosis was not made and for complaint of chest pain landed up to have CABG.

The total ethics of profession was not followed in caring the patient to provide holistic care.

D) the potential plain tiff are the one who accuses and defenders tried to prove them wrong.

E) the argument what I could produce to plaintiff is that the medical reports from the day 1. Nurses notes and their reports. Deterioration of Todd each day without risk assessment with the wound infection which spread all over and made Todd to go for his death.

F) the defence options completely would be hospital records and your examinations. There was no collaboration among the health care professionals. Nurses would have discussed to the physician with good clinical continually.

5) The patient has to get the justice and if it goes to court his licence would be sued and will generally be on stake.

6) the damages that could be awarded are cancelling the registration/licence of their profession. This must be there to set an example that each and every health care professionals must know the negligence act and equality act and its consequences and criteria for caring the patients.