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Respond to these posts:
1. Easter
At the culmination of the scenario, it was determined that the patient had no contribution to the surgical error performed when the incorrect lower extremity was removed by Dr. West. Res ipsa loquitur applies in this case because not only did Mr. Price have no responsibility for the surgery taking place on the wrong body part, but this particular mistake would never occur in the absence of negligence (Pozgar, 2023). In addition, the medical staff maintained control of all instruments throughout the surgical procedure (Pozgar, 2023). As a result, this shifts the burden of proof from Mr. Price to Dr. West and nurse Bobbi White.
Through various conversations, it was concluded that Mr. Price and Dr. West initialed the correct surgical site approximately three hours before surgery. However, during pre-operation, Bobbi prepared the wrong limb. Mr. Price had received sedative medications prior to entering the operating room (OR) and thus was unable to recognize and verbalize that Bobbi was prepping the wrong limb. She admittedly had not reviewed the patient’s chart in over 30 minutes, did not have the surgical consent readily available, reports that the OR is very busy and hectic between cases and states that she was preoccupied with issues surrounding her mother’s health. Bobbi did not follow policy and procedure when prepping the site, stating that she pulled the blanket that was covering Mr. Price just low enough to prep the site but did not think to look for initials placed by the patient and the surgeon. Bobbi also states that in the team meeting that morning, the limb intended to be amputated was not referred to anatomically but instead referred to as “the diseased limb.” Dr. West is unsure if he reviewed the patient’s chart just before the surgical procedure. He reports that he typically has difficulty identifying initials marking the appropriate limb because the patient is already prepped with betadine when he enters the OR. Dr. West reports that the entire team generally confirms the correct site and initials a presurgical checklist confirming they are operating on the correct body part. Dr. West and Bobbi both had a duty to care for Mr. Price and deviated from the standard of care which resulted in patient harm due to their negligence. Individually, both Bobbi White, RN and Dr. Gene West are liable for the negligence in this case.
For the employer to be held vicariously liable, the employees must be performing tasks associated with their job and within the scope of the business (Martin et al., 2022). Bright Road Hospital is liable through respondeat superior given that both negligent parties mentioned above are employees of the hospital (Pozgar, 2023). According to Bobbi, she feels as though it would have been beneficial to have this policy reviewed with her in more detail. However, the procedures known for confirming the correct limb are oftentimes known by the lay person without professional medical knowledge. Therefore, that should not be a viable excuse. Bobbi also states that it would have been helpful in her transition to Bright Road Hospital to have a direct supervisor or a senior nurse shadow her for the first few cases she participated in at this hospital to ensure that she was doing everything correctly. She also states that it is not unusual for the surgeons to forgo confirming the correct surgical site after the patient enters the OR. Bobbi recommends new policies and procedures be written to address these concerns. However, there are already established policies and procedures based on the fact there are pre-procedure checklists to prevent errors such as this. Therefore, staff should be held accountable to following policy and procedure to prevent malpractice and negligence claims. It was difficult to determine the direct liability of the hospital because specific examples of how policy and procedures were lacking. Based on the conversation with Jeff Passmore, some further attention is necessary to address some of the gaps in practice. Thus, Bright Road Hospital is not only vicariously liable via respondeat superior, but they are directly liable due to the lack of policy clarity.
“For every man shall bear his own burden” (King James Bible, 1769/2023, Galatians 6:5). When accepting the duty to care for another individual, healthcare professionals are accepting the responsibility of providing safe care. One must not forget that the tort laws in question are in place to protect the patients we provide care to (Sage & Underhill, 2020). If the defendants are guilty of malpractice, it is important not to assume an adversarial stance and utilize this situation as a means of improving quality and outcomes (Sage & Underhill, 2020). If mistakes are made due to negligence on behalf of the healthcare professional, he or she must acknowledge the mistake and respond appropriately through legal avenues, while incorporating a Christian worldview. “He that covereth his sins shall not prosper: but whoso confesseth and forsaketh them shall have mercy” (King James Bible, 1769/2023, Proverbs 28:13).
References
King James Bible. (2023). King James Bible Online. www.kingjamesbibleonline.org/
Martin, W. J., II., Peters, A. K., Brownback, P.-A., & Cromer, D. S. (2022). Labor and employment law. Mercer Law Review, 74(1), 153-167.
Pozgar, G. D. (2023). Legal Aspects of Health Care Administration (14th ed.). Jones & Bartlett Learning.
Sage, W. M., & Underhill, K. (2020). Malpractice liability and quality of care: Clear answer, remaining questions. Journal of the American Medical Association, 323(4), 315-317. https://doi.org/10.1001/jama.2019.22530
2. Orion
Mr. Price had to get amputee surgery due to being a diabetic and not seeing a doctor after a work injury. This injury resulted in an open wound on his right leg that was not not taken care of and was infected with a staph infection. This caused Mr. Price to see a doctor. He was not diligent with taking care of himself when he knew he had diabetes which also caused injury to his leg, there was nothing that the doctor could do to save Mr. Price’s right leg. This resulted in getting Mr. Price’s leg amputated. Consent is important because Mr. Price signed a surgery consent form that stated what surgery was being performed and on what leg. The duty to care was established when Mr. Price came in for a hospital visit and was told that he needed to get surgery and on the day of surgery  which was on January 11th. Not only did Dr. West initial the leg that was being amputated, Mr. Price initialed as well. There are different forms of consent and  express consent is one of them, but can also be a verbal agreement. This can be a written document that states the act of authorizing medical care (Pozgar, 2019, p. 390). The act of pre-prep work is important because it involves the mishap of amputating Mr. Price’s wrong leg. Pre-pre work involves the patient and doctor’s initials on the correct leg that is going to be performed on, followed by the surgical team going through a standardized checklist that states everything looks good and everyone signs off on the form. This leads the nurse to prep and sterilize the surgical area with betadine solution. The breach of duty was established when the nurse did not check to see which leg was being operated on. The nurse was confused as to which leg was being amputated and did not have the patient’s chart nor signed surgery consent documents. She also didn’t check to see if there were any initials on the leg, which resulted in the injury of amputating the wrong leg. The causation was due to the nurse prepping the leg and not checking to see which leg was being operated on, the cause was also due to Dr. West was not being in the OR during pre-prep work to make sure the right leg was being prepped, or even before he started the surgery. 
    Surgical errors are very common in the medical field due to many reasons. Some reasons include, “Rush to complete cases, absence of standardized rules and regulations, major gap in communication between the surgeon, anesthesiologist, and other ancillary staff, human factors” (Rodziewicz & Hipskind, 2020, p. 15). Nurse White did have family issues going on and it could have been a factor with her judgment, but if that was the case she should’ve let someone know so that she could take leave. Rules and regulations were not so much of an issue here because the policies and procedures were already set in place. Some surgeons are not patient and want to rush to get a case over with which is a statement that Miss. White made. The negligence comes down to nurse White and Dr. West’s actions. They are both at fault under the hospital’s supervision and of course, “Human error is inevitable, but mechanisms can be put in place to ensure that healthcare is as mistake proof as humanly possible” (Al-Assaf et al., 2003, para. 4).  To confirm if Res Ispa Loquitur can be used during the ensuing trail, three conditions have to be met. The event of amputating the wrong leg would not normally occur in the absence of negligence, if the preparation was done correctly then Mr. Price would have lost one leg instead of two. The defendant had complete control of the tool, it did not malfunction of any kind. Lastly, Mr. Price did not contribute to the injury because he was pre-sedated and anesthetized. There was no way for him to double check to see if the doctor and nurse were doing their checks to make sure they had marked the correct leg. All three requirements were met for Res Ipsa Loquitur to be used during the trial. The doctor and nurse are employees under the hospital which falls under the hospital being at fault due to Respondat Superior. The nurse and doctor should take some time off or be fired for their actions. That was complete negligence on both of their parts which could have been prevented. “Though he fell, he should not be utterly cast down: for the LORD upholdeth him with his hand (King James Bible, 1769/2017, Psalms 37:24). Mistakes happen because we are all human, but this mistake could’ve been caught early and permanent damage has been done to Mr. Price.
References:
Al-Assaf, A., Bumpus, L. J., Carter, D., & Dixon, S. B. (2003). Preventing errors in healthcare: A call for action. Hospital Topics, 81(3), 5-12. 
Pozgar, G. D. (2022).?Legal Aspects of Health Care Administration (14th ed.). Jones & Bartlett Learning.?
Rodziewicz, T. L., & Hipskind, J. E. (2020). Medical error prevention. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 
King James Bible. (2017). King James Bible Online.?https://www.kingjamesbibleonline.org/ 
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3 citations and 1 bible verse 
Pozgar, G. D. (2022).?Legal Aspects of Health Care Administration (14th ed.). Jones & Bartlett Learning.?

  
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