Custom-based standards of care are healthcare standards that require medical professionals to provide a reasonable degree of attention, prudence, caution, and concern when providing services to patients. According to Strauss and Thomas (2009), standard of care refers to “the caution that a reasonable person in similar circumstances would exercise in providing care to a patient” (p. 192). Hence, standard of care refers to care that a qualified healthcare provider can offer in a given circumstance. The case study depicts a male patient who arrived at the emergency unit with numerous wounds caused by multiple gunshots and has lost a lot of blood. At the emergency unit, physician and nurses examined and stabilized the patient before taking him into the operating room where he died while undergoing a surgical procedure.
Since the case study appears that there was indivisible harm or negligence, healthcare professionals may be liable for the death of the patient. In this view, as the hospital administrator, I will examine the condition of the patient when he arrived at the emergency unit, the nature of emergency care he received, the surgical procedure performed in the operating room, and the roles played by each of the healthcare professionals. The standard of care in this case is that each of the medical professionals must have provided reasonable care to the patient according to the capacity of the emergency department. Moreover, the case indicates that the physician acted reasonably, as he/she handled the patient’s condition as case of emergency. Some activities such as examination and stabilization took place immediately and shortly thereafter, the physician recommended the transfer of the patient to the operating room. Therefore, as an administrator of the hospital, the facts presented in the case do not provide any substantial evidence of negligence.
Emergency Medical Treatment and Active Labor Act (EMTALA) is an act of the United States, which guides emergency departments on how to handle cases of emergencies that they receive. The act dictates healthcare centers to examine and stabilize all patients who need emergency treatment irrespective of their places of origin, payment ability, or status (Kao, Martin, Das, & Ruoss, 2012). Since EMTALA is an act, it compels all emergency departments to attend to patients in their emergency units. In the case, the patient did not experience any form of discrimination as emergency unit staff examined him and stabilized his condition before taking him into the operating room. Hence, the emergency department complied with the requirements of EMTALA, and thus they made no violation, which would trigger any lawsuit. Thus, there is no reasonable evidence to show that the emergency department violated EMTALA. This implies the death of the patient occurred due to gunshots, which caused excessive bleeding and internal trauma, and eventually led to death.
The issue of informed consent that occurred in this incident is that the emergency staff took the patient into the operating room without considering the consent of the significant others who might have brought him to the hospital. The doctrine of res ipsa loquitor, highlights that, in some occasions, custom-based standard of care may cause unintentional accidents. However, the accident should meet the required conditions and prove that it is an act of negligence on the patient so that an action is undertaken. Rao (2009) argues that a medical professional to be liable for an act or omission, substantial evidence should be present to prove that there is negligence. Thus, in the case, there is no evidence of negligence because the healthcare providers acted reasonably during examination, stabilization, and surgery.
To ascertain whether the physician used the best judgment for the emergency, I would ask questions relating to the extent of gunshots, wounds caused, amount of blood lost, stability of the patient before surgery, and reasons for surgery. Other questions that I consider relevant to the case study pertains to where the patient sustained gunshots and how long it took the patient to arrive at the emergency unit
References
Kao, D., Martin, M., Das, A., & Ruoss, S. (2012). Consequences of Federal Patient transfer Regulations: Effect of the 2003 EMTALA Revision on a Tertiary Referral Center and Evidence of Possible Misuse. Archives of International Medicine, 172(11), 891-892.
Rao, S. (2009). Medical negligence Liability under the Consumer Protection Act: A Review of Judicial Perspective. Indian Journal of Urology, 25(3), 381-371.
Strauss, D., & Thomas, J. (2009). What does the medical profession mean by ‘standard of care?’ Journal of Clinical Oncology, 27(32), 192-193.