Legal and Ethical Issues of a Medical Error Case – Answered

Health care providers are fallible and will make mistakes. Unfortunately, these errors can sometimes have dire consequences for patients, and the providers, as well as the organizations, may be held liable for the harm that resulted.In this Application Assignment, you will analyze a case study of medical error for its legal and ethical implications, and propose ways that a health care administrator might help prevent this kind of error from happening.

Review the scenarios of medical errors in the following readings from this week and select one of them to focus on in the paper.

1. Gallagher, T. H. (2009). A 62-year-old woman with skin cancer who experienced wrong-site surgery:
   Review of medical error. JAMA: Journal of the American Medical Association, 302(5), 660–5 77.
2. Part 1, “Understanding the Causes and Costs of Medication Errors,” pp. 43-45 (Case on the death of the day-old infant), Preventing Medication Errors: Quality Chasm Series (2007), http://books.nap.edu/openbook.php?record_id=11623&page=43.
3. Rosenthal, K. (2004). “Where did this patient’s I.V. therapy go awry?” Nursing, 34(5), 56-57.

Prepare for the paper by considering the following:

• What laws were, or may have been, broken in this case, and by whom? Did you agree with the assessment of liability (if any) provided in the scenario? Why or why not?
• What are the main ethical issues of this case?
• Health care providers are sometimes reluctant to admit wrongdoing, provide full disclosure, or apologize to the victim or family, or they are advised not to by legal counsel, risk managers, or others. Reflect on the discussion in theJAMA article about disclosing errors to patients and families. What are some of the legal and ethical implications of disclosing errors in your selected case?
• What lessons could a health care administrator take from this case? Consider the role of the administrator in establishing and monitoring policies and setting the tone for the organization. Are there ways in which an administrator might help to prevent these kinds of errors from happening?

The Application Assignment:

With these thoughts in mind, write a 3- to 4-page paper in which you address the following questions:

• Summarize the legal aspects of this case. Identify the laws that were, or may have been, broken. Who was, or may have been, liable?
• Did the provider fail in any way to adhere to ethical standards? How might this have impacted the patient outcome?
• If noted in the scenario, how did the provider interact with the patient or family after the error came to light?
• Discuss the pros and cons of having the provider disclose and apologize for the error to the patient or family soon after the occurrence. What are the legal and ethical implications of this approach? In general, how might this approach impact the physicians, nurses, technicians, or others who may have contributed to a medical error that harmed a patient?
• In what ways can health care administrators help prevent the kind of error described in the scenario from happening in the first place? How can they assist the providers and organization after such an error occurs?

SAMPLE ANSWER

The Application Assignment

This paper examines the legitimate aspects of a case that encompass medical and safety errors, which resulted into the death of an infant born to a mother with an earlier history of syphilis. Certainties of the case encompass, abuse of Medication laws- safety and quality procedures, misdiagnoses of infant’s medical problem and treatment, and deficient data about mother’s past treatment for syphilis in relation to the present status of both the infant and the mother. Among these elements, there was difficulty in communication because the parents in this case only spoke Spanish. Eventually, a choice to mistreat the infant for congenital syphilis was because of misdirection and absence of corroboration processes (Quality Chasm Series, 2007).

In order to distinguish laws that were, or may have been broken, who was, or may have been subject, components of negligence must exist. As pointed out by Pozgar (2010), four components must be available for negligence, obligation to give a second thought, break of obligation, harm, and causation. Negligence is a common civil wrong of unintentional commission or oversight of a demonstration that a sensible individual would or would not do under comparative circumstances (Pozgar, 2010). The case proposes, medical attendants or nurses did not apply the necessary knowledge commonly practiced in treatment of a patient.

Infringement of obligation must demonstrate a deviation from perceived standard of care, which implies there must be a failure to stick to a particular duty. Causation is an act that retreats from perceived standard of consideration and must be a reason for harm. For instance, Injury was liable to cause by infringement of obligation, and a damage was predictable, in the present case, death of the infant (Pozgar, 2010).

Due to a shocking death of the infant in this case, facts obviously exhibits a disregard of principles applied by the whole staff, meaning that, laws were broken, Malpractice and Criminal Negligence exist together. For this situation, every member of the health care team is responsible for his or her activities when tending to a patient with trustee obligations to guarantee safety and quality (Pozgar, 2010).

This prompts manifestations of Negligence, Misfeasance, and Nonfeasance. According to Pozgar (2010), Misfeasance refers to as unwarranted execution of an act that leads to damage or injury, in this circumstance, demise of a newborn child as the patient got wrong treatment because of misdiagnoses of a medical problem. Further, Pozgar (2010) says that Nonfeasance is inability to act when there is obligation to go about as a sensible judicious individual ought to do in comparable circumstances, for example, failure to look for a translator as both parents only spoke Spanish which prompted wrong treatment (Pozgar, 2010)

The health care provider failed to adhere to two moral standards. Health Care Professionals have a moral responsibility to their patient and should always serve as advocates to their patients (Pozgar, 2010). The American Nurses Association (2005) Code of Ethics holds fast to advancing patient promotion, striving to secure wellbeing of the patient while ensuring a culture of safety and quality care (American Nurses Association, 2005). Advocacy for patients is a move made in the interest of a person that goes beyond encouraging communication with the sole objective of improving patients’ outcomes (American Nurses Association, 2005).

Effective comprehension of the National Code of Ethics for Interpreters in Health Care, (NCEIHC), ought to have been a focal point towards solving the interpretation problem in the department. NCEIHC (2004) further refers to Ethical understanding conventions as, “When patient’s wellbeing, prosperity, or poise is at risk, a translator or interpreter may offer the necessary support to the patient, and in this way, advocacy must display cautious and keen investigation of circumstances” (NCEIHC, 2004).

This case does not show how the health care providers reacted with the patient or family after the blunder was uncovered. As far as advantages and disadvantages are concerned, having the provider reveal and apologize for lapses not long after a slip event, is a fragile matter however is morally anticipated. For example, the manner in which this approach may impact an apology of a restorative slip, regularly places distortion as admission to blame before realities present themselves, and add to legal ramifications. The motivation behind the ACHE code of morals is to serve as a standard of behavior; benchmarks of moral conduct for human services providers in their expert connections (Lawler, 2000).

Health care administrators can help keep this sort of mistake from happening in two different. In any case, they have to cultivate a culture of responsibility and accountability among the health care providers. This is the best approach to help providers and the organization after such a blunder happens. Second, perhaps reconsidering Health Care Organization statement of purpose reflecting Safety Systems in Health Care Organizations will help keep comparative mistakes from happening. Security Systems in Health Care Organizations look to prevent damage and injury to patients, families, medicinal services experts, contract-administration specialists, and volunteers, and in this manner, whose exercises bring them into a social insurance setting (To Err is Human, 2000). Safety issues that are confronted inside the wellbeing conveyance framework as far as death identified with slips must concentrate on Treatment, Diagnostic, and Preventive Measures.

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