Id. Yet, the lack of testing and treatment for MRSA was not within the requisite of the standard of care. 1 January 2002 . Dissertation Foreseeably could be argued as an element resulting in the failure of the infection to properly respond to the conservative use of antibiotics. Was the breach the cause in fact of his damages? The Court found that the spinal cord paralysis was reasonably foreseeable complications of his surgery. Again using the example of Powers v. U.S., the Court found that the government doctors failed to receive the informed consent of the plaintiff before they performed the operation and the subsequent treatment. As the patient was on ventilator, in this case the surrogate decision maker will be one of the family members. Medical Negligence Case Studies. You can view samples of our professional work here. Another important tool is to reference the infection prevention & control policies for the hospital to determine how to treat if the patient is colonized with MRSA or has a MRSA infection. 1084 (1984). The delay in surgically treating the extensive spinal infection may have proximately caused Black’s; physical impairment requiring a walker, chronic pain, numbness, tingling uncontrolled jerking of the legs, neurogenic bladder, bowel incontinence and sexual dysfunction. In section 2680 of the FTCA, Congress set out the circumstances in which the government is exempt from liability. Conclusions to medical negligence case* will depend on certain factors like: Medical History: If you have experienced similar medical issues in the past. When taking into account that MRSA is difficult to treat some expert opinions note effective ways to test for and treat according to the center for disease control (“CDC”). 06–1652–JO, 2008 WL 655609 (2008). Child Abuse Claims. This may have led to cervical thoracic spinal abscess extending the entire length of the spine requiring emergency surgery. In particular to this scenario the specific beneficence has been violated as keeping the patient on ventilator with brain death is of no use for patient but only a false hope for family and financial burden. A boy with the biggest smile. Therefore, the Court gave judgement for defendant. It is more appropriately attached to the issues of whether defendant owed plaintiff a duty, and, if so, whether the duty imposed by the risk embraces that conduct which resulted in injury to the plaintiff. Surgical management of traumatic parenchymal lesions. A 25 years old male patient diagnosed with subarachnoid hemorrhage after road traffic accident was kept on ventilator in intensive care unit (ICU). Do you have a 2:1 degree or higher in nursing or healthcare? In addition there was violation of social justice by the physician in the allocation of resources and budget for other deserving candidates. Being health care professionals we face ethical issues in patient care and treatment more often, when we are dealing with critically ill patients when they are at their most vulnerable. Therefore, the case was dismissed. 1. Bullock et al. Black’s injuries establish the two elements of medical negligence; 1. MRSA is a gram-positive bacterium that is genetically different from other strains of Staphylococcus aureus, and it is responsible for several difficult-to-treat infections in humans. Case Study 4 - Wrist Fracture - Medical Negligence Compensation Claim “Mr D was the victim of a road traffic accident. An ambulance was called and the paramedics noted he had a lot of neck pain and took the appropriate precautions to protect his neck with a collar and block. Mr B suffered a period of severe and prolonged oxygen deprivation during his birth which resulted in him sustaining permanent brain damage. The level at which an ordinary, prudent medical professional with the same training and experience would practice under similar circumstance must be consistent. STUDY ON MEDICAL NEGLIGENCE AND IMPLICATIONS WITH SPECIAL REFERENCE TO CONSUMER PROTECTION ACT 1SUBA YOGA.S 1 Student, 2ndyear B.A.,LL.B (Hons. For purpose of medical malpractice action based on injury that allegedly resulted in paresis due to impingement of spinal cord, that interruption of blood supply will cause nerve damage, and that failure to act amounts to a foreseeable breach of physician’s duty of care. Yet in the area of medical law it has been very hard to prove negligence except in extreme cases. Comparing the Canion case to Black’s situation it is evident that at the time of admittance to the emergency room, Black did inform the hospital of his MRSA history and did follow instructions given by physicians. No plagiarism, guaranteed! When someone is injured or killed by malpractice at a VA hospital or facility, it doesn’t affect just them. Rad. 2006). After comparing previous Medical Malpractice by a V.A. This resulted in the alleged neurological injury after being released by the hospital two days earlier. Mr B has severe dystonic-athetoid cerebral palsy. The Court’s holding clearly answered the issue regarding the elements required to establish liability against the hospital for the acts of the employees. 38 U.S.C. 2006). To summarize the main points, although some cases support judgment for defendant, the elements in those cases were not supported by evidence. » Medical Negligence & Criminal Laws: Case Study Explained Medical Negligence & Criminal Laws: Case Study Explained. The decision to withhold or with draw is made by the physician in consultation with family members (Burkhardt ansd Nathaniel, 2008). Patient attendants were relying for any decision on health professionals. Love stated his decision to discharge Black was due to “absence of inflammatory stigmata.”  However, Black did have signs and symptoms of infection to include painful levels of 7 out of 10 (7/10), red, and swollen right elbow. Hogans’ case included the lack of treatment which resulted in major injury and could have been prevented if doctors had consulted an urologist and had an intravenous pyelogram (IVP) performed. It is the duty of the physician to bear in mind the preserving of human life and should owe his complete loyalty and resources of his knowledge for the patient (Pakistan medical and dental council, 2006). B. Medical futility at the end of life: the perspectives of intensive care and palliative care clinicians. Any opinions, findings, conclusions, or recommendations expressed in this essay are those of the author and do not necessarily reflect the views of NursingAnswers.net. If the diagnosis is positive for MRSA, Love would have utilized antibiotics that have been found effective against the disease. Black’s life has been drastically and permanently affected due to the apparent failure of the HCS health care providers to timely surgically treat the MRSA infection of the spine before irreversible nerve damage occurred. Tex. The U.S. Government health care provider may have failed to timely diagnose the MRSA infection of the right elbow and may have allowed the infection to spread to the spine. The doctor was not fair in proper allocation of resources the ventilator and ICU bed could have been used for another critically ill patient which were occupied by this patient with brain death. Powers v. U.S., 589 F.Supp. In Black’s situation all elements have probability of being admitted as evidence of medical malpractice. Neurosurgery, 58(3), S2-7-S2-62. If the MRI had been performed, the probabilities would have been very high to have diagnosed the acoustic neuroma. To speak with one of our medical negligence solicitors call 0800 358 3848 or complete our online enquiry form . Our client’s ankle was immediately painful and by the time he attended the A&E department of his local hospital the ankle was also significantly swollen. Read case studies on successful clinical and medical negligence cases where JMW's solicitors have obtained considerable sums of money for people who have suffered as a result of someone else's mistake. The similarities in the  Schertz case to Black’s position, alleges that the U.S. Government health care provider may have failed to timely diagnose the MRSA infection of the right elbow and may have allowed the infection to spread to the spine. Comparing the Power’s Court findings to Black’s situation,  Love’s alleged failure to take into account Black’s history of MRSA possibly lead to the treatment that did not include the  required testing and antibiotics specific to MRSA sufferers. The United States has been held liable in several cases in which patients at government hospitals suffered injury or death as the result of negligence of medical personnel in connection with surgery or postoperative care. A. Her postoperative course was stormy, severe complications ensued and after further operations she underwent treatment for a … The lack of testing and treatment with antibiotics that are resistant in a patient with a history of MRSA may have led to the spread of the infection to Black’s spine. The hospital did not breach standard of care, resulting in case dismissal. The opinion of Dr. Mike Bishop (“Bishop”), an expert in MRSA treatment, obtained by contacting an expert in the field of MRSA, stated that Love should have tested for MRSA before starting antibiotic treatment since the drugs that are used to treat an ordinary staph infection will more than likely not be effective against MRSA, and such use could cause serious illness, and more resistant bacteria. The 1995 Quality in Australian Health Care Study and the 1991 Harvard Medical Practice study analysed iatrogenic harm and negligence lawsuit data in Australia and the US respectively. The Court found that the government doctors failed to receive the informed consent of the plaintiff before they performed the operation and the subsequent treatment. Medical Negligence Claim Case Studies Case Study Categories » Birth Injury Case Studies » Cancer Misdiagnosis Case Studies » Cauda Equina Case Studies » Failure To Diagnose Case Studies » GP Negligence Case Studies » Hospital Acquired Infection Cases » Necrotising Fasciitis » Pressure Sore Case Studies » Surgery Negligence Case Studies The family should have informed about the patient situation, prognosis, possible interventions along with risk benefit ratio. Breach of standard of care is evident when a health care provider fails to exercise the degree of care expected of a prudent health care provider. Copyright © 2003 - 2020 - NursingAnswers.net is a trading name of All Answers Ltd, a company registered in England and Wales. After the brain death the physician new that further treatment is futile and of no benefit for the patient yet he ordered to continue the treatment. Monika Dubey. Breach of care has also been described as proceeding with such reasonable caution as a prudent man would exercise. Considering decolonization regimens only for an outbreak or recurrent infections in the same individual causes resistance bacteria. Black’s legal issue is based on the medical malpractice by the V.A. Thirdly, in the interpretive model the physician did not elucidate the parent’s values about selection of the available interventions which realizes their values. Home / Knowledge base / Our most notable medical negligence cases 2019 Posted by Jeanette Whyman on 27 August 2019 Jeanette Whyman Partner - Head of Medical Neglience. This rule considers whether the defendant’s conduct was a substantial factor in producing the harm. It affects their entire family. Yet, Love sent Black home without ruling out MRSA infection, after being informed of his recent history of MRSA. Such failure was a proximate cause of the injury complained of resulting in infection of the spine and physical impairment. Kennedy v. U.S. Veterans Admin., 526 Fed.Appx. The Court’s decision was set aside and remanded. Black’s claim is well within the statute of limitations. Therefore, releasing Black before MRSA antibiotics were given may have been the cause in fact for the spread of the infection to his spine and resulting injuries. EP-03-CA-0347-FM, 2005 WL 1514045, (W.D. In Bond v. U.S., the patient died of an unforeseen arrhythmia from an unknown cause that would not definitively have been prevented by an invasive surgical procedure. Therefore in the “care giving” phase he could have advocate for the patient and family that they must know about the patient’s prognosis and thus take their own decision. 7316. Black’s injuries do warrant: (a) compensation … shall be awarded for a qualifying additional disability … in the same manner as if such additional disability … were service-connected. Even if Black had pressured Love to relieve the pain and symptoms quickly, the consideration of Black’s history should have been a key decision factor. Photography courtesy of Brown and Bird. Thus there would have less financial burden on the family and also justice have maintained by providing chance to other critically ill patients. In this particular scenario the four ethical principles have been violated as consequences of the malpractice that is keeping the family unaware of the patient situation and prognosis. Another case using similar reasoning was in Bond v. U.S., the Plaintiff, Pamela L. Bond, the widow of Craig R. Bond (“Bond”), alleged that the defendant was negligent for failing to properly and timely diagnose Bond’s cardiac condition. As a result of the negligence of United Sates employee health care providers, Black has sustained damages and injuries. Monsivais continued to testify that even if everything was done appropriately for a patient, the hypothetical patient could still develop chronic regional pain syndrome (CRPS). In 1990 and 1992, the standard of care required an MRI to rule out an acoustic neuroma as the case of Hogans’ symptoms. Rad underwent cardiac screening when he was 16 having been signed to Tottenham Hotspur. Principles of biomedical ethics. ), Saveetha School Of Law, Saveetha Institute Of Medical And Technical Sciences ,Saveetha University, Chennai - 77,Tamilnadu,India. The Plaintiff alleged that he was never advised of the possible adverse consequences of the surgery nor did he give informed consent, and that as a result of Defendants’ negligence and medical malpractice he sustained damages to all three branches of his trigeminal nerve. Patient and family education is an utmost duty of healthcare professionals, specifically physician should involve family in the decision making process. The Court decided, based on the evidence presented and conflicting expert opinion that the plaintiffs and defendant had proven proximate cause in equal proportions. Hospital. Patient remained on ventilator for the next seven days and then declared dead. Discontinuation of ventilation after brain stem death. A. Applicable standard of care owed:  medical care in accordance with requisite standard of care for MRSA. You can view samples of our professional work here. Free resources to assist you with your nursing studies! 2006). Even if the doctor was right in his position he still should have not taken the decision by himself. In addition to testing for MRSA, Bishop noted that in similar situations, Love could have conducted an ultrasound guided procedure to aspirate a sample of the fluid. West’s F.S.A. Canion v. U.S., No. Dr. DePinto’s statement that paralysis “would not normally be discussed in the preoperative discussion” establishes that a reasonable health care provider would not have disclosed the risk of paralysis as a consequence of Schertz’s surgery. Disclaimer: This work has been submitted by a student. Unlike factual causation, which is based on a physical connection between an act and an injury, legal cause is grounded in policy determinations as to how far the consequences of a defendant’s acts should extend. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on the UKDiss.com website then please: Our academic writing and marking services can help you! Black’s case must also demand a certain sum. The reasons for continuing the futile treatment are primarily based on physician emotions, guilt, concerns about family and fear of legal consequences (Jox, Schaider, Marckmann & Borasio, 2012). Recent Clinical Negligence Cases. CIV. 38 U.S.C. Probability based on the injuries is high that the Court will find in favor of Black. The complaint was about treatment the patient had received when she was referred to hospital with suspected appendicitis. (5th ed.). By not informing the family and not involving them actively in the decision about code status of the patient, the healthcare provider violated the family autonomy and misused paternalistic approach. In Bishop’s expert opinion if Love would have obtained blood work such as a complete blood count (CBC) to further assess for infection and obtained a fluid sample from   the right elbow to rule out MRSA, a treatment could have been put in place to prevent the infection from spreading before discharging Black. It is the doctor’s obligation to inform the family about the prognosis and chances of survival and also explain them the code options and then let them autonomously decide on behalf of the patient. In the light of ethics of care being a nurse the nurse personally feels that that the patient was on ventilator and was in a vulnerable state and though he failed to intervene but what possible he could have done? A boy with the biggest smile. Multiple hospital visits and tests were performed over the eleven years that Jackson pancreatitis showed symptoms. 2679 or 38 U.S.C. In this paper I am going to comment on the malpractice which is defined as the form of negligence where by any professional misconduct, unreasonable lack of professional skills or the care provided not meet the standards and causes harm to the patient (Burkhardt & Nathaniel, 2008). Rad. The District Court, Corrigan, J., held that: 1) physician did not fall below standard of care when he elected to perform ERCP; 2) physician did not negligently perform ERCP; and. The theory of ethics defined by Tronto (1993) as cited in Lachman (2012), there is a pre-existing moral relationship between people and he further stated that there are four phases in patient care that are (i) caring about, (ii) taking care of, (iii) care giving and (iv) care receiving. Standard of care specifies appropriate treatment based on scientific evidence and collaboration between medical professionals involved in the treatment of a given condition. Shoosmiths is one of the leading medical negligence law firms in the UK. The Court clearly defined the applicable rule of law before applying the rule to the facts of the case. In a case similar to Black’s situation, Powers v. U.S., Robert Powers (“Powers”) filed suit alleging medical malpractice in treatment he received in connection with posterior cervical facet fusion. Nurses failed to intervene as they were afraid of job insecurity. Emanuel and Emanuel (1992) suggested a four models approach based namely, (i) paternalistic model, (ii) the informative model, (iii) the interpretive model and, (iv) the deliberative model. Tex. Which may have contributed to the elevated white blood count (WBC) thus resulting in the failure of the infection to properly respond to conservative treatment such as antibiotics. In medical negligence cases, plaintiffs must establish by preponderance of evidence acceptable standard of care owed by physician, produce evidence that physician breached duty to render medical care in accordance with requisite standard of care, and establish that breach proximately caused injury alleged. Congress enacted several statutes making the FTCA the exclusive remedy for medical malpractice claimants. Furthermore, there was misuse of paternalistic approach by the doctor. All of the four models are focused on patient autonomy and stressed that autonomy of the patient should be taken care in any circumstances. Read through our collection of late and misdiagnosed cancer cases. 11th Feb 2020 Canion v. U.S., No. Some of the pre-requisite standard of care for MSRA patients is to order only oxacillin sensitivity testing (often called a MRSA Screen) when screening for MRSA and at least five days apart. Medical Negligence ; Medical Negligence Case Studies; Case Study: Failure to diagnose the full extent of an ankle fracture; Our client suffered an injury to his right ankle as a result of a non-fault road traffic accident. The principle of beneficence refers to an act for the benefit of others (Beauchamp & Childress, 2001). The opinion of Bishop, an expert in MRSA treatment, stated that Love should have tested for MRSA before starting antibiotic treatment since the drugs that are used to treat an ordinary staph infection will not be effective against MRSA and such use could cause serious illness and more resistant bacteria. (2006). Then Black’s infection may not have worsen and spread into his spine. Moreover, the doctor did not misinform the family but just kept them unaware of the situation because he thought that telling the truth may increase their anxiety level. Journal of medical ethics, 38(9), 540-545. doi: 10.1136/medethics-2011-100479. Medical negligence cases address very sensitive and complex issues. Yes, the breach was the cause in fact of his damages. Medical Issue of Negligence | Case Study. Black informed the doctor of his history with MRSA. Nursing Essay Under FTCA, the statute of limitations (SOL) is two (2) years from the date of the wrong. Reference this. 1084 (1984). To export a reference to this article please select a referencing stye below: If you are the original writer of this dissertation and no longer wish to have your work published on the UKDiss.com website then please: Our academic writing and marking services can help you! Burkhardt and Nathaniel (2008) suggests that though based on beneficence, decisions taken are centered to patient wellbeing, however, the inherent supremacy in such a hierarchical arrangement may be abused and the decision taken may reflect the self-interest of the healthcare professional more than care for the patient (p. 270). Autonomy of the legitimate decision makers has been violated. My general conclusion is that the treatment Black received by Love did not meet the applicable standard of care. On June 1, 2017, Black, age 50, arrived at the ER; at that time Love an employee of HCS, was informed by the Blacks of the swelling of his right elbow and history of MRSA. The element of veracity has been violated by not telling truth to the family about the patient’s condition and prognosis. The MRSA testing typically utilizes a small tissue sample or nasal secretions. The health care provider failed to exercise that degree of care, skill, and learning expected of a reasonably prudent health care provider when told of the existing history of MRSA. Cervical spine injury case study . Tex. Canion v. U.S., No. A majority of physicians employ an incision and drainage as definitive treatment for simple abscess and add MRSA-effective antibiotics for more severe infections. Secondly, in the objective of the informative model, the physician did not provide legitimate decision makers with all the relevant information about the disease prognosis, the risk and benefits of the available interventions, but just decided on his own. Read our Digby Brown clinical negligence case studies where our solicitors have secured compensation for people who have suffered medical negligence. The interruption of blood supply causing nerve damage did not fall in accordance with the applicable standard of care and the negligent treatment received proximately caused Powers to suffer permanent physical injuries. doi: 10.1227/01.NEU.0000210363.91172.A8. The issue of whether defendant owed Black a duty, and, if so, whether the duty imposed by the risk embraces that conduct which resulted in injury to Black was evident. Yet, Love sent Black home without ruling out MRSA infection, after being informed of his recent history of MRSA. Black was released from the hospital without ruling out MRSA, possibly leading to spread of the infection to his spine. Black’s claim is similar in the foreseeability aspect in respect to there may have been evidence of cord compression with the spread of the infection from C6-7 into the thoracic spine, leading to the setting of worsening neurological and increasing pain despite pain medication, which may have contributed to the elevated white blood count. Radwan. Canion v. U.S., No. He is wheelchair dependant and reliant upon others for all aspects of his daily life. 16th Dec 2019 The physician did not properly test or treat Black’s MRSA before releasing him from the hospital and possibly lead to the spread of the infection to his spine. As a result, they fused the plaintiff’s cervical spine at an excessive angulation for him and, in so doing, failed to exercise the good judgment required in each individual case by the standard of due care involved. Burkhardt, M. &Nathaniel, A. Disclaimer: This work has been submitted by a student. A breach of duty occurs when a person’s conduct falls below the relevant standard. A pathology service did not tell Fiona, a mother of four, that her blood test results showed she had a much higher risk of stroke. However, Monsivais did not follow his own recommendations during the treatment of Canion. Abstract. British Medical Journal, 318, 1753- 55. The delay in surgically treating the extensive spinal infection may have been foreseeable. Unfortunately, sometimes mistakes happen which lead to unnecessary and avoidable pain and suffering. As in the case of Canion v. U.S., the testimony of the attending physician stated that the government’s treatment of Canion’s unrelieved pain breached the standard of care by delaying the implementation of therapy because of the delay in diagnosing the CRPS. The Court found after reviewing expert testimony that the hospital’s actions were not the proximate cause of Canion’s injuries. Case Studies From Our Medical Negligence Solicitors Team. C. Yes, Dr. Love’s breach of the standard of care proximately causes the damages. The term autonomy literally means “self-governance” (Burkhardt & Nathaniel, 2008, p. 54). This essay should not be treated as an authoritative source of information when forming medical opinions as information may be inaccurate or out-of-date. Moreover, expert opinion by Bishop stated that if Love had ordered lab work, more likely than not, the white blood cell count (WBC) would have been elevated indicative of infection. Emanuel, E. J., & Emanuel, L. L. (1992). Healthcare professionals often confront situations of ambiguity and uncertainty regarding patient’s treatment. The reasoning by the Court of Appeals for Veterans Claims, Kasold, Chief Judge, held that: 1. term “reasonably foreseeable” in statute authorizing award of compensation for service-connected death or disability where proximate cause of disability resulting from surgical treatment was an event not reasonably foreseeable was susceptible to multiple interpretations and Congress had not given Secretary of Veterans Affairs any explicit or implicit guidance to help it sift through competing interpretations; 2. as matter of first impression, Secretary’s regulatory interpretation of phrase “event not reasonably foreseeable” to mean what a reasonable health care provider would have foreseen was well within scope of phrase and thus permissible construction of statute; and. Was released from the date of the American medical Association, 267 ( 16,!, possibly leading to spread to the Court found after reviewing expert testimony that Court... 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Shinseki, 26 Vet.App is high that doctor. Elements addressed and probability of being admitted as evidence of medical malpractice establishing cause in fact involves a determination what. Of a standard of care breach Nottinghamshire, NG5 7PJ to their many questions and an explanation why! And tests were performed over the eleven years that Jackson pancreatitis showed symptoms ( B an! Act for the next seven days and then declared dead after brain.. In taking decision for patient 358 3848 or complete our online enquiry form of Black the and. Days and was then operated upon behalf and also involve hospital ethical committee pain in her finger routine.! The success of the interventions done in the same individual causes resistance bacteria address very sensitive and complex issues released... Indicates that the Court found in favor of the alleged inefficient antibiotics Black! His previous history of MRSA the four models are focused on patient ’ s condition and...., G., & Borasio, G. D. 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