IHP420-4-3 Case Study Claims of Negligence PDF

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You listed the 4 D's - great work. However, you did not discuss examples from the case that established or illustrated each element....

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4-3 Case Study: Claims of Negligence Amber Davis Southern New Hampshire University IHP-420-X1604 Ethical & Legal Considerations 21EW1 Dr. Rocio Martinez, DSW, LCSW, MSW, MBA 9/26/2021

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In this assignment I will be analyzing possible claims of negligence and the potential claims of defense presented by the plaintiff. The facts of this case are:

Admission Diagnosis-

A forty-six-year-old-male involved in an automobile accident was brought into the Hospital ER by EMS ambulance. The patient appeared alert and responsive; was able to answer basic questions. The patient was administered fifteen mL of Morphine intravenously for complaints of sufferable pain. The physician recommended the patient needed a blood transfusion, however the patient refused, and consent was denied for following physician’s orders. The patient was thoroughly examined and observed for several hours while in ER department. Subsequently following the patient was moved to the medical-surgical unit floor.

That following morning came around and the patient was found unresponsive and pronounced deceased.

It was discovered that sometime during the night of the accident the patient injected heroin, consumed several shot amounts of tequila, as well as multiple cans of beer. It was later discovered that the patient had a long history of drug and alcohol abuse, however the patient did not disclose this information at the time any of the medical staff were treating him.

Several years after the man had been deceased, his estate sued the physician who treated him alleygating medical malpractice. “Patients may be given 5-20mL of Morphine intravenously or intramuscular route every four hours. “The dosage should be based on the severity of the pain and the response and tolerance of the individual patient (Wockhardt UK Ltd, 2021).”

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https://www.hospicealliance.org/wp-content/uploads/2019/08/morphine.pdf Morphine is given to patients experiencing large amounts of pain. Morphine is used to control pain and comfort the patient. Morphine is not used to help patients die sooner as medical condition of patient’s health is not worsened nor improved by this drug. The side effects of Morphine include sedation, dysphoria, dry mouth, constipation, and myoclonus. “Medical negligence could lead to an overdose of any drug (https://www.medicalmalpracticehelp.com/glossary/overdose-medical-malpractice-law/).” This patient was given morphine 1x during admission by the physician; the patient was not prescribed morphine. One single dosage of morphine in its recommended amount would not be the direct result for cause of overdose. The pain relieving/sedation effects of Morphine last 2-12 maximum hours depending on the quantity amount given and if the drug was in extended-release form. Typically, the effects of Morphine relieve pain for 4-6 hours and it can stay in a person’s system

4 for 12-72hrs after last dose was given. Therefore, what I can be the actual outcome is that the sedative effects of Morphine given to the patient by the physician upon admission had worn off precisely at the time that the patient was moved to the surgical unit floor. What can also now be the most probable scenario is that the patient overdosed due to using heroin, combining that with the strong liquor, and to further commence the sedative effects higher by consuming the additional cans of beer, while being left unattended during that time frame. “In fact, the overwhelming majority of Heroin overdoses are caused by combining the drug with sedatives like alcohol (Hillard, 2021).” It is unknown how the patient obtained heroin, tequila, and beer all at once while in the hospital’s care treatment facility. The most probable conclusion is that the patient called a visitor to bring those substances to him. Patients are allowed to receive guests and not all guests properly check in with the receptionist desk attendant. If the staff would have been made fully aware of the patient’s drug and alcohol abuse, the likelihood that this patient would have received supervision is greater than in this situation where the last thing staff are expecting is for a patient to call a guest to visit them and bring in illegal substances and prohibited items into the hospital setting. “Using semi-synthetic opiates like heroin carries a high risk of fatally overdosing. Recognizing a heroin overdose is happening and acting quickly can save a person’s life (The Recovery Village, 2021).” There are vital ways that overdose effects can be reversed if caught in time, unfortunately the staff were caught entirely off guard by the illicit actions taken by this patient. Usually, patients who are admitted into hospital situations are wanting to receive life-saving care and treatment and do not commence to result to the illicit outcomes that this patient chose. The automobile accident that brought the patient into admission at the hospital appears like a possible attempt to commit suicide. It could also be possible that the patient refused blood transfusion ordered by the physician to delay/ mitigate life-saving attempts.

5 Being that the patient was conscious and alert there proves even more likelihood that the patient made the conscious phone call to an outside person to arrive at the hospital where the patient was located at to deliver the illegal substance and prohibited alcohol. This behavior is consistent with suicidal tendencies and drug and alcohol abuse. In order to obtain a judgement for negligence against a physician (defendant), the patient or in this case the patient’s estate (plaintiff) must be able to show a summary containing all four D’s negligence. 1. Duty 2. Dereliction or Breach of Duty 3. Direct or Proximate Cause 4. Damages or Injuries Duty occurs when an obligation is established between the physician and the patient, or health care provider and the patient, in order to provide the patient with a certain standard of care. Dereliction or breach of duty occurs when the physician or healthcare provider has failed to provide a correct standard of care to the patient and, therefore, has not net the duty, resulting in injury to the patient. Direct or proximate cause exists when the patient’s injury is a direct result of the negligence of the physician or healthcare provider. Damages are a financial or other award granted to the patient as compensation for the injury.

6 References: Wockhardt UK Ltd. (2021). Morphine Sulfate 15mg/ml Injection BP. EMC Datapharm. https://www.medicines.org.uk/emc/product/2245/smpc#companyDetails

Glare P, Walsh D, Sheehan D. The adverse effects of morphine: a prospective survey of common symptoms during repeated dosing for chronic cancer pain. Am J Hosp Palliat Care. 2006 Jun-Jul;23(3):229-35. doi: 10.1177/1049909106289068. PMID: 17060284. https://www.hospicealliance.org/wp-content/uploads/2019/08/morphine.pdf

https://www.medicalmalpracticehelp.com/glossary/overdose-medical-malpractice-law/

https://www.healthline.com/health/how-long-does-morphine-stay-in-your-system#How-longdoes-it-take-for-the-effects-of-morphine-to-wear-off

https://www.cdc.gov/drugoverdose/deaths/heroin/index.html

The Recovery Village. (2021). Heroin Overdose. https://www.therecoveryvillage.com/heroinaddiction/heroin-overdose/

Hillard, J. (2021). Alcohol and Heroin. https://www.alcoholrehabguide.org/alcohol/drinkingdrugs/heroin/ The Recovery Village. (2020). What Happens When You Mix Heroin and Alcohol? https://www.therecoveryvillage.com/heroin-addiction/faq/mixing-heroin-alcohol/

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