Case Summary
The case under investigation includes the surgeon’s wrong actions, which led to the patient’s death, in Iturralde v. In the Hilo Medical Center USA (2012) case, Rosalinda Iturralde went to court to hold Hilo Medical Center (HMC) and its practicing surgeon, Robert Ricketson, accountable when, due to the surgeon’s actions, the plaintiff’s brother Arturo Iturralde died due to problems after surgery. Arturo Iturralde entered the hospital in January 2001, where he received a spinal fusion surgery appointment from Dr. Ricketson.
The operation was carried out a few days later, and during its course, an absence of two titanium rods essential for implantation was discovered. Having decided not to wait for the delivery of the new rods, Dr. Ricketson used parts of a stainless-steel surgical screwdriver instead. A few days later, the rods broke, leading to further surgery, complications, and the patient’s death in 2003 due to problems arising (Iturralde v. Hilo Medical Center USA, 2012). The case provides an example of a clear violation of medical practice standards.
Legal Components
Analysis of the case allows consideration of its components and establishes the nature of the problem. Four components that support the analysis of the case are as follows: “duty, dereliction or breach of duty, direct or proximate cause, and damages or injuries” (Fremgen, 2019, p. 125). The duty assumes that the specialist will act reasonably as other professionals in a similar situation (Fremgen, 2019). Dr. Ricketson was required to implant titanium rods based on the patient’s interests.
Dereliction or breach suggests that the specialist did not act as the professional should in the situation under study (Fremgen, 2019). Improper inventory and the selection of the wrong replacement for rods indicate the presence of this element. The direct cause of this event led to injury, and in the case of Iturralde v. Hilo Medical Center USA (2012), the reason is the surgeon’s decision to use improper rods. Finally, the issue includes damages since the patient was injured, and the court awarded compensation.
The presence of the four components described above in Iturralde v. Hilo Medical Center USA, suggests that the nature of the issue is negligence. The rules of the doctrine of res ipsa loquitur in medical malpractice apply to this case. The doctrine implies that the defendant had control over the situation, and if not for his actions, the injury would not have occurred (Fremgen, 2019). Dr. Ricketson’s misconduct led to complications and death, and following the standards of practice would help avoid negative consequences.
Malpractice Policies
Despite the high standards of practice, errors are still common. Therefore, specialists use professional liability insurance, also called malpractice policies. Such insurance allows medical professionals to cover damages in the event of neglect or a mistake (Fremgen, 2019). Dr. Ricketson is forced to cover losses independently in the case under investigation since he did not have malpractice insurance (White, 2006). The disadvantage of his position highlights the importance of malpractice policies in medical practice, especially for surgeons.
Standard of Care
The case under study includes several violations of standards of care and laws that should guide medical practice. In particular, following the standards, specialists should act reasonably and in the way that their colleagues would act in similar situations. Moreover, medical staff are obligated to tell patients the truth, provide complete information, and obtain informed consent for any procedures (Fremgen, 2019).
Dr. Ricketson breached the standards because he used an disapproved implantation method, did not receive consent from the patient, and forbade reporting it. Moreover, as previously established, the case contains elements that correspond to negligence, which is consistent with the law of malpractice. Consequently, Dr. Ricketson breached the laws and standards of care when providing services to the patient.
Impact on Healthcare Consumers from Different Cultural Backgrounds
A person’s cultural background determines views on medicine and often affects medical literacy and the ability to communicate with hospital staff. For instance, in the studied case, if people had considered the outcome of the treatment from the perspective of the intervention of the highest forces as fate or God, they would not have claimed the surgeon. Language could also be a barrier to discussing the case and the overall treatment process, worsening the situation. Moreover, if the treatment of Dr. Ricketson or other HMC specialists affected members of various minorities, the cases would cause significant distrust of the hospital and suspicion of discrimination and cultural incompetence. For these reasons, medical professionals must know how to work with patients from different cultures.
Accountability
Investigating the case requires assigning accountability to the culprits. The court initially awarded 65% liability to Dr. Ricketson and 35% to HMC (Iturralde v. Hilo Medical Center USA, 2012). The surgeon’s decision did not meet medical standards, leading to negative consequences for the patient.
HMC, in turn, failed to study Dr. Ricketson’s history of violations in other states where he was stripped of his license to practice. However, following a review of the case, the allocation of accountability was changed, and 75% was assigned to the patient’s previous conditions and 25% to HMC (Iturralde v. Hilo Medical Center USA, 2012). As the case demonstrates, assessing accountability requires attention to various factors, the study of medical history, and expert opinions.
References
Fremgen, B. F. (2019). Medical law and ethics (6th ed.). Pearson.
Iturralde v. Hilo Medical Center USA, No. 28792 (3rd Cir. 2012). Web.
White, N. (2006). Hawaiian jury finds doctor liable for inserting screwdriver in patient’s spine. Lawyers Weekly USA. Web.