The Lewis Blackman Case: Ethics, Law, and Implications for the Future Medical errors in decision making that result in harm or death are tragic and costly to the families affected. There are also negative impacts to the medical providers and the associated institutions (Wu, 2000). Patient safety is a cornerstone of higher-quality health care and nurses serve as a communication link in all settings which is critical in surveillance and coordination to reduce adverse outcomes (Mitchell, 2008). The Lewis Blackman Case 1 of 1 point accrued On Thursday November 2, 2000, 15 year old Lewis Blackman checked into Medical University of South Carolina Children’s Hospital (MUSC) in Charleston for elective surgery on his pectus excavatum, a congenital …show more content…
Dr. Tagge, the lead surgeon, finally updated the family over two and a half hours later stating that Lewis did well even though he had to reposition the metal bar four times for correct placement (Kumar, 2008; Monk, 2002). Helen reported wondering if Dr. Tagge had realized how much Lewis’ chest depression had deepened since he last saw him a year ago in the office, especially considering he did not lay eyes on Lewis until he was under anesthesia the day of surgery (Kumar, 2008). In the recovery room, Lewis was conscious and alert with good vital signs, listing his pain as a three out of ten (Monk, 2002). Nurses and doctors in the recovery area charted that he had not produced any urine in his catheter despite intravenous hydration (Kumar, 2008; Monk, 2002). Epidural opioid analgesia was administered post-operatively for pain control, but was supplemented every six hours by intravenous Toradol (Ketorolac) (Kumar, 2008; Solidline Media, …show more content…
Dr. Murray, the chief resident who arrived around 8:00pm, charted Lewis’ heart rate as normal and noteds a probable ileus; however, nursing documentation at the same time recorded a heart rate of 126 beats per minute (Monk, 2002). Subsequent heart rates at midnight and 4:00am arewere charted as 142 and 140 beats per minute respectively without documented intervention (Monk, 2002 ). On Monday morning Lewis noted that his pain suddenly stopped after being very constant and staff charted that they were unable to get a blood pressure recording in either arm or leg from 8:30-10:15am despite trying multiple machines (Monk, 2002; Solidline Media, 2010). At noon, while staff were having difficulty attempting to draw blood, Lewis became unresponsive. Helen called for help and Dr. Murray arrived to the room (Monk, 2002). A code was called and the on-call physician, Dr. Adamson, arrived and subsequently attempted to resuscitate Lewis for an hour before calling a time of death at 1:23pm (Kumar, 2008; Monk, 2002). An autopsy later revealed that Lewis Blackman died from internal bleeding caused by a perforated ulcer with close to three liters of blood and digestive fluid
Paramedics deemed the patient competent and therefore Ms. Walker had the right to refuse treatment, which held paramedics legally and ethically bound to her decisions. Although negligent actions were identified which may have resulted in a substandard patient treatment, paramedics acted with intent to better the patient despite unforeseen future factors. There is no set structure paramedics can follow in an ethical and legal standpoint thus paramedics must tailor them to every given
Today, there are so many legal dilemmas dominating trial for the courts to make a sound legal decision on whose right in a complicated situation. Despite the outcome of the case, the disagreement usually has a profound effect on the healthcare organization, and the industry as a whole. Many cases are arguments centered around if the issue is a legal or moral principle. Regardless what the situation maybe, the final decision is left to the courts to differentiate between the legality issues at hand opposed to justifying a case based on moral rules. According to Pozgar (2012), an ethical dilemma arises in situations where a choice must be made between unpleasant alternative. It can occur whenever a choice involves giving up something good and suffering something bad, no matter what course of action is taken (p. 367). In this paper, I will discuss cases that arose in the healthcare industry that have been tried and brought to justice by the United States court system.
Healthcare creates unique dilemmas that must consider the common good of every patient. Medical professionals, on a frequent basis, face situations that require complicated, and at times, difficult decision-making. The medical matters they decide on are often sensitive and critical in regards to patient needs and care. In the Case of Marguerite M and the Angiogram, the medical team in both cases were faced with the critical question of which patient gets the necessary medical care when resources are limited. In like manner, when one patient receives the appropriate care at the expense of another, medical professionals face the possibility of liability and litigation. These medical circumstances place a burden on the healthcare professionals to think and act in the best interest of the patient while still considering the ethical and legal issues they may confront as a result of their choices and actions. Medical ethics and law are always evolving as rapid advances in all areas of healthcare take place.
In conclusion, the death of Mr. Ard was the result of negligent behavior by the on duty nurse. If the nurse would have followed standard policies and procedures the patient outcome would have been different. This would include being more attentive to the patient’s call button, as well as, performing standard respiratory tests given the patient’s condition. There was also a failure to properly review documentation, and add new notations to patient’s medical chart as needed. In the end, the court of appeals should have found the hospital negligent in the death of Mr. Ard.
In the case Lunsford v. Board of Nurse Examiners, the nurse had an unprofessional conduct by violating a duty to her patient leaving the patient unattended and at risk of complications (BON, 2013a). Lunsford, as a professional nurse had the responsibility to assess the patient’s medical status and treat the patient within her scope of practice taking the appropriate measurements to prevent the worse, regardless of the doctor’s orders of sending the patient to another facility. “The Board of Nurse Examiners in Texas suspended the nurse’s license to practice after the Board found that the nurse’s conduct was unprofessional and dishonorable conduct likely to injure the public” (Wolf, 1986, p. 222). Nurse Lunsford fail to take the patient’s vital signs, and did not implement the nursing interventions required to stabilize the patient’s condition or to prevent complications. Her conduct is considered an “unprofessional conduct,” which is any act, practice, or administration that does not conform the accepted standards of nursing practice. Also, this case is a clear example of the nurse responsibility and accountability to act independently regardless of the physician’s order when this order is not safe for the patient. If the nurse has any objections about an order, the nurse has the obligation to question the physician. By no doing so, the nurse violates the nurse-patient relationship and put at risk the patient’s safety. In a situation, in which a physician’s order put the patient at risk, the nurse has the obligation to exert her professional judgement and withdraw from rendering services ordered by the physician (Wolf, 1986, p.
...iately discovered and the patient was fine, but had there been proper communication between the healthcare staff, such blunders could have been avoided altogether (Dolanksy, 2013).
On October 16th, 1846 the world of surgery changed forever. Taking place in the Ether Dome at Mass General Hospital was the surgical removal of a tumor in a man’s neck. The surgeon was the world renowned Doctor John Warren. Before Doctor Warren could slice into the man’s neck, William TJ Morten, a dentist, ran into the room. He presented a bag filled with a gas called Ether, and swore that he could erase all of the patient’s pain. He had tested this gas on himself, his dog, and his goldfish. Doctor John Warren gave him permission to try out this relatively untested gas on his patient. For the first time in surgical history, the Ether Dome stayed silent throughout the surgery. No screaming, no flailing, and no burly men needed to hold the patient down (Decoding The Void). Soon Doctors all over the world were using general anesthesia, and history was made.
After review of the timeline of the events surrounding Mr. B, there are several causative factors that led to this sentinel event. These are inappropriate staffing, inability to identify trends of deterioration, policy for conscious sedation was not followed, inadequate observation and monitoring, failure to respond to alarms, inadequate home medication evaluation, medication dosing, appropriate medication administration times, and failure to start cardiopulmonary resuscitation in a timely manner.
In this essay the author will rationalize the relevance of professional, ethical and legal regulations in the practice of nursing. The author will discuss and analyze the chosen scenario and critically review the action taken in the expense of the patient and the care workers. In addition, the author will also evaluates the strength and limitations of the scenario in a broader issue with reasonable judgement supported by theories and principles of ethical and legal standards.
Today, the medical industry has been transformed. Doctors must live by a different code of ethics other than their oath. Legal fear has put the doctor-patient relationship in jeopardy. Today, physicians view patients as potential malpractice litigants. Therefore, doctors order unnecessary costly tests or avoid treating patients to insure safety from lawsuits. In Chicago, emergency room personnel refused to care for a boy who was shot, and had collapsed thirty feet outside the hospital door, because their legal duties were only to those inside. Because of the fear of lawsuits, the young boy was denied the opportunity to live. Not only are doctor-patient relationships affected, teachers and students are learning under precise laws.
“Whoa-oa-oa! I feel good, I knew that I would now. I feel good….”. My “I feel good” ringtone woke me up from the depths of slumber during my first night call in internal medicine rotation. My supervising intern instructed me to come to the 4th floor for a patient in distress. Within moments, I scuttled through the hospital hallways and on to the stairs finally arriving short of breath at the nurses’ station. Mr. “Smith”, a 60 year old male with a past medical history of COPD was in respiratory distress. He had been bed bound for the past week due to his severe arthritis and had undergone a right knee replacement surgery the day before. During evening rounds earlier, he had no signs of distress. However, now at 2 AM in the morning, only hours later since rounds, he was minimally responsive. My intern and I quickly obtained the patient’s ABG measurements and subsequently initiated a trial of BIPAP. This resolved Mr. Smith’s respiratory distress and abnormal ABG values. To rule out serious causes of dyspnea, a stat chest x-ray and CT were obtained. Thankfully, both studies came back normal.
Several ethical principles that are incorporated in the nursing care of patients on a daily basis are nonmalificence, autonomy, beneficence, justice, fidelity and paternalism. Nurses should strive to comply to as many of the principles as possible. In this case there are principles which support and conflict with the wishes of the patient. The first principle that supports the wish of the patient is autonomy. Autonomy means that competent patients have the right to make decisions for themselves and the delivery of the healthcare that they receive. Another factor that would support the patient’s wish to not be resuscitated is nonmalificence. Non maleficence means that nurses should not cause harm or injury to their patients. In this case the likelihood of injury after resuscitation was greater than if the patient were allowed to expire. A principle that could have negatively affected the outcome of the provision of ethical care was paternalism. Paternalism is when a healthcare provider feels that they know what is best for a patient, regardless of the patient’s desire for their own care. I demonstrated the principle of paternalism because I thought that I knew what was best for the patient without first consulting with the patient or family. This situation might have had some very negative consequences had the patient not have been competent. Practicing a paternalistic mindset might have caused a practitioner in the same instance to force their ideas about not resuscitating the loved one onto the family. This could have caused a sense of remorse and loss of control of care amongst the
Life is all about the decisions we make. In fact, the average individual makes 35,000 decision each and every day (Hoomans, 2015). For the healthcare professional, decisions are founded on ethical theories with the pillars of beneficence, non-maleficence and justice as the tools for decision making (Morrison & Furlong, 2014). The ability of health care professionals to apply these theories determines whether or not an appropriate response is achieved in healthcare situations. Unfortunately, at times a professional who has consistently violated the policy for ethical conduct through poor decisions must be disciplined.
Nurses have many duties assigned outside of routine patient care. The heart of nursing care is ensuring patient safety. An ethical dilemma exists when there may or may not be violations of law by other health care professionals. The balance between protecting patients and not making capricious allegations against others can be a delicate tightrope. Proceeding through prescribed channels in reporting possible infractions requires faith the truth will be revealed and proper actions taken. However, in the case of the nurses in Winkler County, Texas, the nurses’ faith was misplaced. Although the nurses, Mitchell and Galle, filed nine claims for relief, three of them are particularly relevant
There are many different types of therapies, techniques, and treatments that can be performed with a patient. Some patients are even victims in yheir situation, so any trauma or stress related to an offending incident should be dealt with and alleviated. In cases such as these, management is faced with the task of medical investigation. This is essentially a series or collection of hearings and investigations into the patient’s incident, to gather all relevant data. Digging into a patient’s personal life or situation can create a vast range of ethical issues, that may involve a health provider using their own judgement. A common issue with scenarios such as these, stems from certain medical decisions being left up to the physician and management. Following certain legal procedures, can still take a manager to a crossroads where they must make a medically ethical decision on behalf of their medical staff as well as on behalf of the patients in care. It has become the job of a hospital's designated ethical committee, who bears the responsibility to make sure that all medical staff are aware of the agreed principals of ethical decision making, to create consistency and protocol in common situations. This committee will essentially define certain acts as ethical in specific and common situations, so a provider can make a decision for that certain situation, regardless of any