Medical Malpractice: Caring Memorial Hospital

Legal Malpractice Case
Medical malpractice occurs when a hospital, an advanced practice nurse, or other healthcare professional causes an injury to a patient through a negligent act of commission or omission, in the area of diagnosis, treatment, or healthcare management. The medical malpractice case reviewed in this paper involved a patient, Yolanda Pinellas, a 21-year-old female student at Ithaca College who was studying to become a music conductor. Yolanda was diagnosed with anal cancer and was admitted to Caring Memorial hospital to receive Mitomycin for her chemotherapy. Standards of care were not followed in the intravenous (IV) administration of vesicant Mitomycin, and there was an IV infiltration of the vesicant. Two weeks after the

infiltration, Yolanda had necrosis in her hand which resulted in multiple surgical procedures and permanent loss of function and deformity of her third, fourth and fifth fingers. Yolanda alleged that, because of this loss, she was no longer able to achieve her ambition to perform as a music conductor, and therefore sued for damages. The purpose of this paper is to discuss the legal aspects of the malpractice case regarding the patient Yolanda Pinellas whose hand developed necrosis while being cared for at Caring Memorial Hospital.
Liability Issues
A patient has the right to expect that health care professionals will provide care that is consistent with the standard of care.

When the standard of care has not been met, then negligence or breach of duty may be established. Liability is the responsibility for the consequences of one’s act of omission or commission. Liability issues involved in the malpractice action brought by Yolanda Pinnelas against Caring Memorial Hospital consisted of the permanent loss of function and deformity of her third, fourth and fifth fingers. These damages occurred following infiltration of vesicant Mitomycin that was administered intravenously in her hand. Two weeks after the infiltration, Yolanda had necrosis in her hand and this resulted in multiple surgical procedures and consequent permanent loss of function and deformity of her

fingers.
Yolanda’s life ambition to have a career as a music conductor was stultified because of the loss of function and deformity in her hand.
When a patient suffers injuries as a result of the negligence of duty by a healthcare professional(s), the patient can bring on a medical malpractice liability suit against the professional(s) and or the institution. Corporate liability is the legal accountability of a corporate entity like a hospital for matters beyond the control of the employees and in some cases for the wrongful conduct of the employers. (Westrick, 2014). In this medical malpractice case, Caring Memorial hospital has the corporate liability for its staffing and administrative deficiencies and the wrongdoings of the staff who cared for Yolanda while on admission in the hospital. The responsibility is on the plaintiff to prove the essential elements of a lawsuit, which are to establish that there was a duty, a breach, an injury and that the injury was caused by the breach of duty.
Parties Involved
The parties involved in this case are the Plaintiff, Yolanda Pinnelas who initiated the lawsuit and those who could be sued (defendants) comprise of the nurses (Jeffrey Chambers RN, Carol Price LPN, Diana Smith RN), nursing supervisor (Betty DePalma, RN, MS), administrative staff (Susan Post, Amy Green) and the hospital. The hospital is very much involved in this liability by virtue of corporate liability and respondeat superior in which the organization answers for the misconduct of the employees. Jeffrey Chambers was the assigned staff nurse who hung the vesicant chemotherapy by himself without observing the two persons’ double safety check. Carol Price was the LPN who did not attend to the beeping infusion pump. The pump beeped several times but she ignored it as she thought someone else was caring for the patient. Dianna Smith RN was also working the shift and had heard the pump beep several times. She mentioned it to Jeffery but she did not go into the room until about forty-five minutes later. Betty DePalma is the nursing supervisor who was responsible for safe care of patients under her care and supervision. Susan Post was the risk manager, and Amy Green was the quality assurance personnel.
Defenses of Parties

To successfully defend against a negligence suit, the defendant will strive to negate one of the essential elements of the plaintiff's cause of action.

The defendant could argue that he or she did not owe a duty to the plaintiff, that there was no breach of duty, and that injury sustained by the plaintiff was not caused by the breach of duty. (Mello, Studdert, & Kachalia, 2014). Jeffrey Chambers, the assigned nurse, could argue that there was a shortage of staff and he had many other very sick patients he was caring for at the same time. He could also argue that he was working back to back and did not have enough rest before coming back to work. He could also state that he was assigned the responsibility of caring for Yolanda though he was not certified in administering

chemotherapy.
The other nurses could all claim they were short staffed and could not respond promptly since they were engrossed in taking care of many other very sick patients. Carol Price LPN could argue that administration of and monitoring of chemotherapy were outside her scope of practice and competence. The nurse supervisor could say she was depending on the assigned nurse to monitor the patient closely and to ask for help if help was needed. She could also argue that the nurse who discovered the faulty infusion pump, should not only have reported it, but should have labeled and put the faulty pump away. The quality assurance and risk management personnel could argue they were aware of staffing shortage and were in the process of making recommendations to the hospital management.
The hospital could argue that the nurses should have spoken up instead of accepting patient assignments that were not safe and that the staff did not act in a professional safe manner, acted outside the policy, and broke the rules and protocol of patient safety in the discharge of their duties. The hospital could also argue that the necrosis which occurred two weeks after the IV infiltration could be a result of metastasis of patient’s aggressive anal cancer, and was not related to the infiltration of vesicant Mitomycin. Mello, Studdert, & Kachalia, (2014) emphasized the need for nurses to practice carefully within their scope of practice and standards, explaining that malpractice lawsuits are becoming a disturbing aspect of modern clinical practice. When a nurse accepts a patient assignment, the nurse is legally obligated to provide competent safe care. If there is negligence or malpractice present, the nurse is held accountable and could suffer liabilities from lawsuits and disciplinary action from her board of nursing, up to revoking her license.
Documents
The use of patient-related documents in a malpractice lawsuit provides a crucial evidence when a malpractice or negligence is suspected. A proof is necessary to present the case proving that the plaintiff's injury and suffering were caused by the defendant (Bjorklund, 2016). According to Taylor (2014), documents and medical records are used heavily as evidence to show proof of negligent practice. The use of medical records is necessary for the plaintiff’s lawyer to build a case and gather evidence against the defendant or defendants. Parts of medical records include billing, laboratory test results, providers notes, and all records of communications between those who are involved in the patient’s care. To bring a malpractice lawsuit forward, a certificate of merit is needed to demonstrate the necessity of the trial. Documents are then evaluated by an expert physician to bring a malpractice lawsuit forward. Also, the materials are necessary to create evidence that negligence and damage to the patient have occurred due to providers failing to meet standards of care (Kroushar, 2008).
Yolanda Pinellas developed necrosis of the hand after her intravenous access became dislodged from the vein during the infusion of the chemotherapeutic drug Mitomycin. In a malpractice litigation, the documents that are required include medication administration records. Also, documentation of who inserted Ms. Pinellas intravenous line and assessment documentation before administering the drug are required. Moreover, the plaintiff’s lawyers will require the notes of the actions taken after the intravenous line was determined to be infiltrated giving the legal team and the expert physician a picture of what transpired that day. All of these documents are needed and will be used to provide proof that damages occurred because the providers failed to meet standards of care (Jenkins & Lemak, 2009).