Introduction
The standard of care usually plays a significant role in lawsuits involving negligence by healthcare providers. Depending on the evidence that each opposing side may have, it is required that they prove beyond a doubt for a judge to be able to give a final verdict. As such, this essay dwells on three medical negligence cases to simplify the determination of the standard of care. The evidence sources that will be key to proving the alleged negligence include documentation from the healthcare facility, the patient’s medical history, and treatment plans.
Objectives
The purpose of this comprehensive analysis will be to examine and critically evaluate the standard of care that is typically provided in healthcare facilities. To do so, the paper analyzes three cases in Guido’s textbook that present potential nurse or facility negligence that caused harm to the patients. Moreover, it would determine how a judge could leverage the evidence to render a sound verdict in negligence cases.
Chapter Five Case: Apparent Cardiac Event
The standard of care this patient received before and after visiting the clinic is documented in various documents. The first crucial step is assessing the patient’s medical and health records. The visitation schedules of the deceased with the medical facilities are also essential in expounding on the encounters he has had with the medical staff of the clinic. The essence of comparing the patient’s old data with current records is to clearly understand his health struggles and how the clinic has been responding to them (Guido, 2020; Weiner et al., 2022). Moreover, test reports, other potential health risks identified, and the treatment plans he was under could be used to ascertain if the clinic acted responsively and accordingly regarding his cardiac event. Other sources of evidence could include diagnostic reports and results, as well as clinic policies and protocols.
One aspect that stands out in the case is that the nurse never took the time to understand the prior incidents and the victim’s condition. Instead, the nurse rushed and ordered X-rays and an electrocardiogram based on the information the patient provided at the time. This is highly negligent behavior for a nurse or medical practitioner to ignore a patient’s medical history when deciding on an intervention plan (Weiner et al., 2022).
Thus, the family attorney, in a supplemental report, can allege various failures of the clinic to support the wrongful death claim. For instance, he may assert that there was a failure to assess the victims’ symptoms for appropriate medication adequately and a lack of inquiry into the patient’s medical and health history during the visit. Other factors include inadequate diagnostic testing, communication failure, and language barriers.
Deciding on standard care for this patient, who experienced an apparent cardiac event, encompasses the evaluation of various factors. According to Guido (2020) and Pozgar (2020), an institution’s guidelines and protocols for a specific disease are essential for providing appropriate care. These often outline the recommended diagnostic procedures depending on the symptoms nurses observe in patients.
Furthermore, consulting a cardiac specialist would have been essential, as the specialist’s insights could have led to appropriate care plans for the patients (Kozel et al., 2021). Analyzing medical and health history records can also ensure that the patient receives standard care. Other critical determinants of his appropriate care may include assessing diagnostic measures, ensuring proper communication and follow-up, and evaluating the response to the given intervention.
The outcome of this case relied heavily on the evidence presented to establish the standard of care the patient received. As a judge handling this case, I would have examined the evidence to determine whether the clinic’s healthcare providers considered the patient’s prior medical history. I would also have analyzed medical records to assess the quality of care received.
Furthermore, the decision in this case would depend on the communication and follow-up plans. If there were unaddressed lapses, then there was substandard care. Finally, benchmarking the nurses’ procedure in dealing with this patient against the institution’s set guidelines would also be crucial in determining the outcome of this case.
Chapter Six Case: Retained Tubing after Surgery
Given the unusual incident, which is uncommon in surgical procedures, it may be argued that the plaintiff had valid grounds to rely on res ipsa loquitur to prove to the court that the incident resulted from the nurse’s negligence. However, Guido (2020) argues that the application of res ipsa loquitur depends on whether the facts are sufficient to establish the failure alleged. First, if the plaintiff can prove beyond a doubt that such an occurrence is usually due to negligence, this element may be satisfied.
Moreover, the procedure was exclusively under the defendant’s control. As such, the nurse should have been careful when removing the tube, thus satisfying the element. Based on the facts of the case, it is crystal clear that leaving a 4.25-inch piece of tubing in surgical sites is unnatural and could only occur due to negligence.
The expert witness testimonies only introduce a counterargument to prove that the nurse acted responsibly and appropriately, and that the 4.25-inch tubing retained was an accident. However, the expert’s verbal evidence does not necessarily negate a successful res ipsa loquitur outcome. According to Guido (2020), the res ipsa loquitur doctrine is an established rule that allows a plaintiff to claim negligence following an incident that causes harm.
Thus, the considerations that will affect the res ipsa loquitur outcome will depend on the quality of the expert testimony. This implies that the jury handling this case must assess the credibility and authenticity of the provided evidence. If, in any case, the defense expert persuasively refutes the incident as negligence, the res ipsa loquitur argument will weaken.
Proving the nurse’s negligence requires examining additional facts and details contained in other documentation about this patient. For instance, medical records outlining the procedures and protocols followed during the surgery are crucial (Weiner et al., 2022). The history would also provide the type of surgery and the purpose of the drainage tube, to determine whether it was appropriate and necessary per the institution’s guidelines and policies. Benchmarking the nurse’s adopted procedure against the hospital’s policies and protocols for drainage tube removal may also be used to determine if the nurse acted negligently. Finally, the expert’s opinions may be considered evidence in ruling negligence as the root cause of the retained tube.
Whether the damages incurred, such as pain and medical expenses, are to be assessed depends on whether the court finds res ipsa loquitur substantial enough to outdo the defendant’s pieces of evidence. If so, there will be a need to examine the extent of damage and costs to determine a suitable compensation plan for the plaintiff. Other factors to be considered in evaluating the indemnities include causation and the nature of the harm. As a judge, I am responsible for providing the case outcome. I will base my decision on the proof of negligence, examine evidence that sufficiently links the nurse’s actions to the incident, and determine whether to grant or reject the application of res ipsa loquitur.
Chapter Seven Case: Surgical Fire Negligence and Fraudulent Concealment Lawsuit
This case presents a scenario where a patient incurred second-degree burns when the surgical team activated the Bovie instrument, leading to a fire. According to Nasri et al. (2022), damages may be awarded only if the plaintiff proves that the surgeon’s negligence caused the fire when the Bovie was activated. Otherwise, the incident may be treated as an accident and thus does not meet the recompense threshold. As such, if the evidence subsequently indicates that the surgeon deviated from the standard of care, then the damages were liable to be paid due to negligence. Moreover, the plaintiff may have to present substantial proof of concealment allegations against the hospital staff for the court to determine the cost of such misconduct.
Identifying the individual most liable for this incident entails examining the surgeon, the nurse anesthetist, and the hospital’s role in the operation. For instance, the surgeon, mandated to ensure safety in the surgery room, is liable for the damages. According to Nasri et al. (2022), it was the surgeon’s obligation to ensure that all medical procedures were performed appropriately, including the handling of the Bovie instrument.
The nurse anesthetist may also share responsibility for the damages resulting from the fire. The nurse was responsible for monitoring or overseeing the sedation and oxygen levels. If it could be proved that the nurse failed to provide standard monitoring, leading to the fire, the nurse is as guilty as the surgeon. Finally, the hospital may be liable only if it lacks standardized policies to guide such treatments and if it can be determined that its workforce is incompetent.
However, considering the damages, the hospital staff, the defendants in this case, could cite several defenses that could reduce their liability. According to Guido (2020) and Pozgar (2020), healthcare providers can present several defenses in court to argue for their innocence and for compliance with the standard of care. These include an informed consent form, adherence to the standard of care, and no fraudulent concealment. The defendants, for instance, could argue that they provided the patient with informed consent outlining the risks and dangers of the procedure, which the patient accepted.
Moreover, the staff must demonstrate that they provided standard care and complied with all protocols and guidelines in accordance with medical practice. Finally, the accused in this case needs to argue in court that they acted responsibly, informed the patient of what happened during the incident and the injuries, and offered appropriate treatment plans. As a judge deciding on the damages award, the key components to consider in my verdict will be whether the defendant was negligent, the nature of the harm, the medical expenses incurred, and the pain suffered. I will also weigh the evidence against fraudulent concealment to determine if the healthcare facility acted inappropriately.
Conclusion
As the three medical negligence cases present, determining a standard of care requires thorough consideration of diverse factors. These include patent records, institution policies and guidelines, and communication culture. The factors would help a judge determine whether the incidents in the cases were caused by the nurses’ or the hospital’s negligence and assess the damage, enabling a suitable compensation strategy to be planned. However, the judge must evaluate the evidence from both sides to serve justice.
References
Guido, G. W. (2020). Legal and ethical issues in nursing (7th ed.). Pearson.
Kozel, B. A., Barak, B., Kim, C. A., Mervis, C. B., Osborne, L. R., Porter, M., & Pober, B. R. (2021). Williams syndrome. Nature Reviews Disease Primers, 7(1).
Nasri, B.-N., Mitchell, J. D., Jackson, C., Nakamoto, K., Guglielmi, C., & Jones, D. B. (2022). Distractions in the operating room: a survey of the healthcare team. Surgical Endoscopy.
Pozgar, G. D. (2020). Legal and ethical issues for health professionals (5th ed.). Jones & Bartlett Learning.
Weiner, S. J., Schwartz, A., Weaver, F., Galanter, W., Olender, S., Kochendorfer, K., Binns-Calvey, A., Saini, R., Iqbal, S., Diaz, M., Michelfelder, A., & Varkey, A. (2022). Effect of electronic health record clinical decision support on contextualization of care: A randomized clinical trial. JAMA Network Open, 5(10).