Goal and Objectives
The main purpose of this study is to analyze simulated cases to improve future practice. The study will address the adequacy of evidence for examination and diagnosis. In addition, the review of compliance with patient care standards and a review of the requirements to meet this standard will be conducted. During the analysis of cases, it is necessary to evaluate the actions of the nurses and doctors and analyze their expediency, and compliance with ethical and moral standards and legislation. The paper will address the complex problem of medical error and the concept of negligence, which can lead to a negative outcome for patients. It is necessary to touch upon the important moral issue of responsibility for medical shortcomings. In the course of a detailed analysis of cases, the skills of critical thinking and behavior when faced with moral dilemmas will be implemented. The future specialist needs to know the current legislation and the need to comply with ethical standards, so the study is useful for learning objectives. The analysis of negative clinical cases contributes to the development of an understanding of practices aimed at maximizing a positive treatment outcome.
Evidence
To determine the level of care for the patient, it is necessary to address the completeness of the actions of nurses. The first evidence includes an initial clinical encounter in which the patient claimed that there was no more pain associated with the cardiac event (Guido, 2020). Despite this, the nurse insisted on an electrocardiogram and radiography (Guido, 2020). The fact that the results of these studies were normal may be evidence. Before the examination at the clinic, the court can take into account the conversation with the nurse when making an appointment at the clinic, as evidence. Even though the pain was sharp and atypical, the nurse did not insist on an urgent visit to the clinic.
Attorney Statement
The family’s attorney will likely argue that standards of care for the patient were violated, leading to his death. The attorney can point to the fact that medical professionals did not insist on urgent hospitalization. The patient underestimated his problem, so he made an appointment for the next day instead of calling an ambulance (Guido, 2020). An attorney can write that a professional nurse could identify heart problems by pain symptoms and insist on urgent hospitalization. Even though the patient claimed that the pain was gone, and the results of his research were within the normal range, the nurses still should have insisted on additional examinations.
Standard of Care
Standards of care are implemented daily in all aspects of health care delivery and all practice settings, forming the basis for quality, competent health care delivery. Standards of care are the critical aspect that determines the outcome of lawsuits in multiple clinical settings (Pozgar, 2020). The behavior of the nurses of the clinic where the patient applied did not meet the standards of care. The patient did not receive sufficient information about the severity of his situation after contacting the clinic by phone, and could not realize the need for hospitalization. The nurses in this case had to convince him to go to the emergency room. In this case, a basic standard of care that requires patient safety was violated (WHO, 2018). Moreover, after visiting the clinic, the nurses were not convinced that the condition caused by heart problems had passed. It was necessary to order additional examinations and convince the patient to stay in the clinic for observation.
Outcome
The outcome of the case must be determined in favor of the affected family. The patient was given insufficient care, the medical staff had to conduct additional studies to make sure the patient was safe. After first contacting the clinic by phone, the medical professionals had to insist on going to the emergency room. Part of the patient’s death is the result of neglect on the part of the nurses.
Res Ipsa Loquitur
The term res ipsa loquitur defines a situation in which a person inflicts harm as a result of exclusive control. In court, the plaintiff may rely on this term even if there is no direct evidence of negligence (Prayitno, 2020). In this case, the plaintiff could also rely on res ipsa loquitur in formulating the indictment. Even though the nurse did not deviate from the standards of care, she was the only person who had control over the situation and could leave a piece of plastic tubing unremoved.
Witnesses
The defense provided evidence from expert witnesses who stated that the nurse’s actions were up to standard. Even though the prosecution did not provide witnesses, this will not affect the successful outcome of the res ipsa loquitur case. The point of this term is that further evidence is unnecessary since the nurse is the only person who had control in this situation (Prayitno, 2020). That is why the defense is not obliged to provide its witnesses since the evidence is considered redundant.
Other Factors
There are not enough facts in the case to determine with certainty whether the actions of the nurse about the patient were negligent. Since the nurse’s actions are said to be up to standards by the experts, the problem could be in the tube itself. It is necessary to determine the manufacturer, and the material of the tube and identify whether there have been similar cases with similar tubes. The nurse’s guilt will be greatly mitigated if it turns out that the tube was of poor quality.
Assessing Damage
In this case, it may not be easy to assess the damage, for this, there is not enough medical data. Since the patient did not immediately seek help, it cannot be said that he experienced physical suffering due to the tube inside. It is necessary to find out how the object affected the health of the patient. Such factors may be the beginning of the inflammatory process, the worsening of biochemical parameters, and the deterioration of the general well-being of the patient. Based on the factors obtained, it will be possible to approximately estimate the damage.
Decision
The decision must be in favor of the plaintiff. In any case, no matter who is more at fault: the nurse or the manufacturer of the poor-quality tube, the patient was physically injured and had a high chance of a serious deterioration in health. A nurse cannot be relieved of responsibility, despite the statements of expert witnesses. It was necessary to carry out additional control to make sure that there were no foreign elements left in the patient’s body.
Damages
Damage that must be compensated occurred during the operation to remove moles. The patient suffered second-degree burns on the left side of her face, permanent scarring, and blurred vision in one eye (Guido, 2020). In addition, compensation will have to include non-pecuniary damage, which will irreversibly entail the irreversible loss of the original appearance of the patient’s face. The need for compensation for the damage caused remains beyond doubt, however, it is necessary to determine who and to what extent is responsible for this safety violation during the operation.
Responsibility
The injuries to the patient during the operation occurred due to a collective disregard for safety rules. However, the most responsible for the incident is the surgeon, who is obliged to control the entire process from the preparation stage to the completion stage. Perhaps the surgeon did not know how to competently work with this type of instrument or neglected the technical safety requirements. The doctor had to know that oxygen can increase the risks of a fire hazard and did not take this into account. Perhaps, in the case of this procedure, it was necessary to offer alternative types of anesthesia. Moreover, the patient was hardly warned about such risks.
Defenses
One of the main defense arguments for leniency may be the non-prevalence of such cases and the lack of awareness of such risks on the part of the medical team. The defense side can write off what happened as an accident due to poor-quality equipment. The prompt action of the medical team saved the patient’s life, which was threatened by this accident, which is also a mitigating circumstance. The patient was given appropriate care after the incident, which can be taken into consideration by the court. The patient was not aware of the risks of this procedure, but the doctors also could not assume such an outcome of the actions.
Court Decision
The court must take into account both the physical injuries and mental suffering of the patient. Compensation should be made up of these two factors. In such cases, compensation usually consists of assessed moral damage, funds spent on the rehabilitation period, and procedures aimed at minimizing physical and aesthetic harm (Barnes et al., 2019). The decision on malpractice and deliberate deceit can be rejected by the court because the doctors were not aware of the possibility of such an emergency. Most likely, the hospital will bear most of the costs, partly the responsibility will fall on the operating surgeon. In addition, further investigation of the case is necessary to find out why the problem occurred and whether the manufacturer of the tool should be held liable.
Conclusion
Medical cases are difficult to legally interpret because they require maximum patient protection while avoiding disproportionate punishment for medical personnel. Violations of standards of patient care, negligence, and medical errors lead to negative consequences for the patient’s health. In each case, it is necessary to specify in detail who is responsible. Often, the mistakes of medical personnel come from the wrong systemic policy of medical institutions. Lack of promotion of quality communication with patients and substandard equipment lead to death and injury to patients. To avoid such cases, it is necessary to create a clear organizational culture in which the staff will comply with the moral and ethical standards of the medical profession.
References
Barnes, M., Flaherty, J., & Bierer, B. E. (2019). Research subject injury compensation: the ongoing search for fairness, consistency, and clarity. The Journal of Law, Medicine & Ethics, 47(4), 748-750. Web.
Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.). Prentice Hall.
Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.). Jones and Bartlett.
Prayitno, W. (2020). Application of Res Ipsa Loquitur to the Medical Negligence Case in Patient Protection Perspective. In International Conference on Law, Economics, and Health (ICLEH 2020) (pp. 292-305). Atlantis Press. Web.
World Health Organization. (2018). Delivering quality health services: A global imperative. OECD Publishing.