Case Study Claims of Negligence PDF

Preview

Summary

Download Case Study Claims of Negligence PDF

Description

Case Study Claims of Negligence Laura Griffieth Ethical and Legal Considerations Southern New Hampshire University

For this case study we are looking into a case involving a 46 year old male who was taken to the hospital and admitted into the emergency room following an automobile accident. The patient seemed to be alert and coherent enough to answer basic questions. The doctor decided to administer 15milligrams of morphine intravenously without doing a thorough examination and patient history. The patient then needed a blood transfusion but, refused it and the patient was then moved to surgical ward for monitoring. However the next morning the patient was found unresponsive and unable to be revived. It was later discovered that this patient had a long history of drug and alcohol abuse. The patient early in the evening had taken several shots of tequila and several cans of beer. The question remains could this patient have been saved if the provider had done things differently? This patient died of a drug overdose that could have been prevented. There are several things the doctor could have done to prevent what happened. First the provider could have done a thorough physical examination on the patient, second the provider could have ordered a toxicology screening, and third the provider could have given the patient Naloxone prior to administering any pain medications. Any time a patient is being brought into the Emergency room a thorough history needs to be obtained if possible. This falls under the patient being owed duty of care which is an element of negligence. This means the provider and the staff should have asked how the patient got into the accident. They also should have asked about any and all medications the patient had taken that day prescription or illegal ones. In this case the patient was coherent so the doctor should have taken the time to do physical examination. This means the doctor should have checked the

patient’s eyes. “Changes in the eye, such as pupil size, motion, and color of the whites, can be used to assess whether a person is intoxicated” (Thomas 2020). The doctor should have checked the patient over from head to toe for any and all injuries. During that examination the doctor should have found the patients track marks. The track marks would have given away the patients drug use and could have prevented the patient from receiving the morphine. All of these things should be done to provider reasonable care. This also falls under the breach of duty because of the provider’s inactions in this case it caused the patient’s death. One way the provider could defend this claim is if this particular patient was very good at hiding his track marks the provider would have never seen them during the examination. The provider could also state that patient failed to disclose the previous drug use the patient lied to them. The patient also could have also lied about how the accident happened so the doctor felt no need to dig further for the cause of it. The doctor should have ordered a toxicology report. If the patient was in an accident the police would have been involved and would have wanted to take to the patient about what happened. With the patient being in an accident a toxicology screening should have been ordered. Not only a toxicology report but other lab work to test the patient’s internal functions to make sure there was not more going on with this patient. By simply just giving the patient the morphine blindly he allowed the morphine to cause an overdose. “Heroin is an opioid drug made from morphine, a natural substance taken from the seed pod of the various opium poppy plants” (Drug abuse.gov 2020). Since heroin is made from morphine giving the patient morphine only caused the overdose. Giving the patient the morphine caused the damage which is the causation element of this case.

The doctor can defend the not getting a toxicity screening as impending on patients’ rights. Many emergency rooms do not request a toxicity screening unless it is seen as absolutely necessary or the patient is not coherent. In this case the patient may have been able to convince the provider he was completely with it and not under the influence of any drugs. The doctor can say they did not feel the need for a toxicity screen because it would have delayed in treating the patient. The provider could have gone ahead and gave the patient the medication needed to reverse the opioids in his system either prior to giving the morphine or afterwards when they had the time to do lab work at any time during the night. “Naloxone is a medication designed to rapidly reverse opioid overdose” (Drug abuse.gov). Once the patient was moved to another ward he should have been monitored closely for any sign of changes. The overdose would have been apparent. The doctor can defend this by stating the patient showed no indication of needing Naloxone at any point. The doctor can fight with the fact that the patient refused the transfusion which can just as easily been the cause of the patients death or played a role in it. The provider can argue had the patient gotten the transfusion it would have flushed some of the meds of his system and with the increased blood volume it could have decreased the effects of the drugs. This patient died because the provider failed to do his duty and provide the proper standard of care in the ER which was giving him a thorough examination and collecting a thorough history. Had the provider done what should have been done the patient would have been found to be under the influence and the proper medication Naloxone could have been given

to counter act the effects of the drugs the patient had already taken. This patient’s death could have been avoided. I think when looking at this case the one to me that may have the most success against the provider is the subdural hematoma claim. The patient was in a car accident which means he should have been thoroughly examined for any indication of head trauma. This means not just checking the eyes but sending him for head scans that would show the hematoma. The provider failed to do what he should have done and caused the patient’s death.

References National Institute on Drug Abuse. (2020, July 24). Heroin DrugFacts. Retrieved November 22, 2020, from https://www.drugabuse.gov/publications/drugfacts/heroin National Institute on Drug Abuse. (2020, October 09). Opioid Overdose Reversal with Naloxone (Narcan, Evzio). Retrieved November 22, 2020, from https://www.drugabuse.gov/drugtopics/opioids/opioid-overdose-reversal-naloxone-narcan-evzio Reviewed by Scot Thomas, M. (n.d.). Drug Effects on Eyes: Redness, Dilated & Pinpoint Pupils. Retrieved November 22, 2020, from https://americanaddictioncenters.org/healthcomplications-addiction/signs-drug-use-eyes...