Week4repliestopeerspost.docx

Kashiera Jones-Sims
In the case study that we have been assigned for this week’s discussion board, there is a patient that had been admitted to the hospital for a procedure and during admittance, the patient had been identified as Mrs. Smith. Mrs. Smith has made the allegation that there was negligence that was done after the surgery was completed during the examination in the post-operation. From the account of Mrs. Smith and Mr. Smith, she was in the waiting area for the post-op when the Chief of Surgery, Dr. George Paltrow came into the recovery area to perform his evaluation of all of the patients. During the examination, there was a note that had been made that Dr. Paltrow did not change his gloves after he had completed the evaluation of each one of his patients nor did he wash his hands as required. Following the evaluation, Mrs. Smith had contracted a staph infection that caused her more illness and had prolonged her stay within the hospital to thirty days. There have been a number of witnesses who have been identified and have been interviewed. In the interviews, the determination was made that all of the parties involved had been members of the hospital staff and not private contractors which brings the case in a whole other direction.
In the case, the problem of duty of care had been called into question since the idea of duty means the establishment of a legal obligation unto which the safety and security of another is imposed. The duty of care became in effect when the patient who was Mrs. Smith was in their care and had the supervision of Dr. Paltrow including the assigned nurse during the evaluation in post-surgery. Pozgar (2019) states that an organization owes its patients a duty of care, and the duty includes the obligation to protect them from negligence and fraudulent acts of those physicians with a propensity to commit malpractice (p. 172). The physicians in a hospital has to be able to provide the highest and considerable amount of care for any patient that is under their care including seeking the expertise of medical professionals. Morris et al (2019) stated, “All healthcare practitioners know that they owe their patients a duty of care (p. 647). The duty of care had been defined already since the patient had been in the care of Dr. Paltrow and Nurse Brainard while post-op care was being provided. This is a crucial component that must be determined if the patient would even want to begin to proceed with the filing and possibly winning a lawsuit for negligence.
The first of the determination factors in the case study would be the idea of breaching of duty. Pozgar (2019) defines breach of duty as the failure to conform to or the departure from a 
required duty of care owed to a person (p. 50). When Dr. Paltrow was making his assessment of the patients and made the decision to not change his glove nor wash his hands as mandated, he violated the standard of care that had been owed to his patients that deserved a quality level of care. To be able to properly determine if a breach of duty occurred, we must be able to understand the policies and procedures that the hospital has including what a reasonable care provider is expected to do. According to the case study, if there is a policy that exists for the handling of gloves, the way to change them and disposal once usage is done then that should be followed. Whilst interviewing Nurse Brainard, she mentioned the fact that many of the staff within that department did not practice the proper standards of glove changing and handwashing. The nurse also indicated that she had expected for an incident such as this to occur due to the behaviors that she had seen from the staff members. Morris et al (2019) stated, “The issue of whether a healthcare practitioner breached their duty of care to their patient is central to clinical negligence claims (p. 647). Once review of the presented facts is complete, there is a breach of duty that has obviously occurred since Dr. Paltrow did not follow the policy or procedures and did not practice safety protocols for the patients nor standards of care. Another point to remember is that the staff members were also employees of the hospital who did not take the time to inform either Dr. Paltrow nor the administration of what Dr. Paltrow was doing and allowed for a delay in the treatment and care of Mrs. Smith.
    The second of the determination factors in the case study would be the injuries that had been caused or received to the patient due to the negligence. The very essence if civil liberty certainly consists in the right of every individual to claim the protection of the laws, whenever he receives an injury (Pozgar, 2019, p. 20). In many occurrences either medical or not, an injury that is one that is caused from pain, suffering, loss of income, harm physically or even to one’s reputation. Mrs. Smith was injured due to the physician’s breach of duty and duty of care being violated which resulted in a staph infection that had not been there prior to admittance into the hospital’s care. The injury had been reaffirmed when the pulmonologist, Dr. Holly Brigham and the infection disease team made the determination that Mrs. Smith received a staph infection that had traveled from her lungs which can cause an autoimmune disease. The staph infection is one that can affect her life and cause her death if untreated or treated incorrectly or even not found in time. Since the nursing staff did not take the time to advise any personnel of the actions of Dr. Paltrow, the injuries could have been left for a period of time can cause a delay in the possible treatments and the overall outcome. The malpractice frameworks are intended to provide compensation and justice for negligently injured patients (Krauss, n.d., p. 1). In the end, the actions had occurred after the surgery was done and the patient had suffered injuries due to the negligence of the hospital and this gives good credence to the lawsuit of Mrs. Smith to the staff as well as the hospital as a whole.
    The element of causation requires that there be a reasonable, close, and casual connection
or relationship between the defendant’s negligent conduct and the resulting damages (Pozgar, 
2019, p. 52). Mrs. Smith had not been the only patient to receive the staph infection as Nurse Brainard said, she said that all of the patients that was under the care of Dr. Paltrow had been infected and this is a result of negligence. If she were to be the only patient to have receive the infection, the case would have been more difficult to prove. Graham (2020) concludes that the search for casual connection between damage and negligent act or omission requires consideration of the events that have happened and what would have happened if there has been no negligent act or omission (p. 21). Nurse Brainard mentioned that all of the patients had acquired the same exact type of infect that Mrs. Smith did which can be determined that the doctor, the staff and the hospital had been responsible for the injury to Mrs. Smith. Due to the negligence of Dr. Paltrow of not following the proper protocol of changing his gloves between caring for his patients nor washing his hands, the patients under his care became seriously ill with an autoimmune disease. The most reasonable piece of information to note is that the other staff members such as the nurses had been completely aware of the negligence though did not take the time to notify the doctor due to either fear of reprisal or fear in general. The nurses  did not take the time to even talk to an administrator and discuss the negligence that had occurred. The violations had been known while the steps had not been properly taken to ensure the safety, security and care of the patient which should have done to prevent any type of harm to the patient which violates the right of the patient to proper or quality care.
In the end, after the careful review of the case study and the listening of all of the interviews for all of the involved parties within the hospital workplace, there seems to be the possibility of danger where a lawsuit of malpractice being issued. Each one of the parties that was involved had been members of the staff which means that the hospital has liability for any kind of neglect, damages or injuries that had occurred with the patient when they were in their care. Since the individuals are not contractors privately, the hospital has to assume the responsibility for the negligence that occurred on their watch. The care of the patient that had been provided was negligent and this means that the physicians including the hospital that they are employed at as well as the other staff members are at risk of a possible malpractice lawsuit that is being filed by the patient due to the negligence all of the involved parties. According to King James Bible Online (2021), Ezra 4:22 states, “Take heed now that ye fail not to do this: why should damage grow to the hurt of the kings?” This bible verse is one that expresses that negligence can be translated to one who is a sloth, lazy, or careless. This is not the representation that God would want to have in the kingdom that he has since this is not productive and can cause harm. This can be harmful due to the carelessness and lack the patience to get things done correctly without any fault to anyone. The Chief of the hospital has to be able to have the comprehension that negligence has occurred in the incident where all parties including the hospital needs to be held accountable and liable for if the case move forward where the court needs to be ruled upon. 

References:

Graham, D. (2020). Causation Problems in Medical Negligence Cases. Precedent (Sydney, 
N.S.W.), (157), 20-29.
King James Bible Online. (2021). Ezra 4:22. Accessed June 10, 2021 from, https://www.kingjamesbibleonline.org/Ezra-4-22/
Krauss, E., Shankar, V., Patterson, J., & Mackinnon, S. (n.d.). Medical Malpractice in Nerve 
Injury of the Upper Extremity. Hand. Accessed June 10, 2021 from, https://doi.org/10.1177/1558944720906500  
Morris, C., Gautam, C., & Francis, T. (2019). Clinical Negligence: Duty and Breach. British 
Dental Journal, 226(9), 647-648. doi:http://dx.doi.org./10.1038/s41415-019-0312-9 
Pozgar, G. D. (2019). NVPMD: Legal aspects of health care administration. 13E-Liberty Custom. Burlington, MA: Jones & Bartlett. ISBN: 9781284170931.
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Week 4 Discussion Post
Allison Arthur
With the rise in the number of people receiving healthcare comes the rise of malpractice lawsuits brought against healthcare professionals. Medical malpractice lawsuits are brought on when a healthcare provider is negligence when handling a patients care. Medical malpractice is defined as “improper, unskilled, or negligent treatment of a patient by a physician, dentist, or healthcare professional leading to medical malpractice” (Nilegaonkar & Padmaj, 2019). With the steady increase in medical malpractice cases, it is important to understand why a malpractice lawsuit might be brought against a healthcare professional. In to understand this, we must first analysis what goes in to proving negligence. The four elements of proving negligence include; duty to care, breach of duty, injury, and causation (Liberty University Custom: Pozgar 2019). Like most professions, medical professionals live by a code of ethics. In the code of ethics, there are a list of standards of care that healthcare professionals are required to follow (Adejumo & Adejumo, 2020). In to prove the first element in a medical malpractice lawsuit, one must be able to prove that the healthcare professional in question had a duty to care, or if there are standards of care that they must follow that they did not (Liberty University Custom: Pozgar 2019). Once the first element has been proved, then you move on to the second which is breach of duty. For this element, one must establish that the specific duty to care was breached. The third element to prove is if there was an injury or not. Lastly, one must determine if the injury suffered was directly from the breach of duty that the healthcare professional displayed. Turton, (2020) describes the fourth element of proving negligence as when “a claimant must establish that the defendant’s negligence was a but-for cause of, or a materially contributed to, the damaged suffered.” In other words, the defendant must prove that the cause of the injury was directly related to the healthcare professional’s negligence or breach of duty.
Now that we have established the four elements of what it takes to bring a medical malpractice suit about, we can look at the example from the Jones and Bartlett website “law learnscape interactive episode.” In this interactive episode, there was an incident were a patient developed a life-threatening staph infection and a negligence lawsuit was filed. We must figure out if the four elements of proving malpractice was established. The patient in question was Mrs. Smith. Mrs. Smith received a staph infection, believed to come from a doctor’s failure to change their gloves between patients. Throughout the episode many hospital staff directly involved in Mrs. Smith’s care were interviewed about the events leading up to and after the staph infection was present and being treated. We can see from the episode that the duty to care has been established due to the doctor providing care for Mrs. Smith after her surgery. This was established because the patient was admitted to the hospital. This shows that the doctor has a legal obligation or relationship to care for the patient. The breach of duty to care was also established. The breach of duty can be seen because of the patient receiving the staph infection from the doctor who failed to change gloves between patients, this information comes from interviews from hospital staff. It can also be established that the hospital staff took too long to respond to the staph infection establishing a further breach of duty to care. There is also no doubt that there was an injury stemming from the breach of duty. The conclusion of the staph infection, from several healthcare professionals, was that the failure to change gloves between patients was what caused Mrs. Smith to receive the staph infection. The first patient that was seen before Mrs. Smith was reported to have a staph infection and then the following three patients, including Mrs. Smith received a staph infection from the gloves that were used on the first patient seen. Causation was also established. This was established because it is hospital policy to change gloves and wash your hands between patients which the doctor failed to do. My recommendation would be that duty to care was established between Mrs. Smith and Dr. Paltrow due to the admittance of Mrs. Smith the hospital and the fact that the doctor is an employee of the hospital. Duty to care was breached because the hospital has a policy, although not clearly stated, to wash hands and change gloves between patients and there was a failure to due that in this case. The injury was also established because Mrs. Smith received the staph infection from the hospital employees failure to comply with policies. The causation of this case was also established. The causation stems from the failure of hospital staff to change gloves between patients resulting in the staph infection Mrs. Smith received. The causation is further established because of the time in took for medical staff to begin treating Mrs. Smith for the staph infection. Overall, I think that the negligence lies with the hospital in this case. The negligence is due to the improper signage and enforcement of its policies by the hospital. Had there been proper signage, education, and enforcement of the importance of hand washing and changing gloves between patients, this incident could have been avoided.
While exploring my own thoughts on medical malpractice, and this particular situation, I am reminded of my own beliefs and how they might play into the actions one makes in the medical field. Parker (2017), states that People do not make ethical judgments in a cognitive vacuum. Behind our ethical judgments are background beliefs that can materially affect how we come to judge actions as morally prohibited (wrong to do), required (wrong not to do), or permitted (neither wrong to do nor wrong not to do).” These beliefs, whether they be religious or not affect ever action that we make. Therefore, in the word of legality and ethics in the healthcare realm one must always consider their own beliefs and choices when making recommendations and reviewing cases and how they could affect the situation if not used properly when handling cases of medical malpractice. To sum up, I am reminded of the verse from Matthew 7:12 “So whatever you wish that others would do to you, do also to them, for this is the Law and the Prophets” (The Holy Bible, 2011). This reminds us as Christians, in the case of ethics, to remember ourselves and how we would want a situation handle fairly and justified if we were in the shoes of the other parties. This reminds us to always treat others how we would want to be treated and make judgements based on our principals and faith and to always remain fair and just.
References
Adejumo, O.A. & Adejumo, O.A. (2020). Legal perspectives on liability for medical negligence and malpractice in Nigeria. The Pan African Medical Journal, 35. http://dx.doi.ezproxy.liberty.edu/10.11604/pamj.2020.35.44.16651
Liberty University Custom: Pozgar, G. D. (2019). NVPMD: Legal aspects of healthcare administration. 13E-Liberty Custom. Burlington, MA: Jones & Bartlett. ISBN: 9781284170931.
Niglegaonkar, S. & Padmaj, K. (2019). Medical Negligence. Indian Journal of Medical and Pediatric Oncology, 40 (4); 552-553. http://dx.doi.org.ezpoxy.liberty.edu/10.4103/ijmpo.ijmpo_261_19

Parker, J.C. Religion, Authenticity, and Clinical Ethics Consultation. HEC Forum 31, 103–117 (2019). https://doi-org.ezproxy.liberty.edu/10.1007/s10730-019-09375-7

The Holy Bible. (2011). New International Version. Biblica INC.
Turton, G. (2020). CAUSATION AND RISK IN NEGLIGENCE AND HUMAN RIGHTS LAW. The Cambridge Law Journal, 79(1), 148-176. http://dx.doi.org.liberty.edu/10.1017/S0008197319000898