State Medical Association Case Study Nursing

For this week’s discussion I have read the article assigned this week regarding HIPAA violations. I will summarize the case against the physician and what the HIPAA law states. I will also discuss what the penalties are for a HIPAA violation and if this physician could have faced further charges.

As noted, on February 29, 2016, the patient was nonetheless admitted to the UCR hospitalist. This was a senior member of the UCR hospitalist team who knew or should have known all of the policies and procedures for admission, and should never have admitted the patient as an attending to the hospital. In so doing, he was directly and deliberately interfering with the doctor patient relationship.

The blood vessel that Dr. Eltahawy was concerned about was thin and looked as though it would collapse in on itself. First, Dr. Eltahawy tried a balloon catheter. At the top of the catheter was a small balloon that could inflate to maintain a shape or structure of a blood vessel. However, because the blood vessel was so thin, the balloon catheter was not very effective. Instead, Dr. Eltahawy installed a stent. A stent is a wire mesh tube. It is placed in a blood vessel permanently to maintain the shape of the vessel and to allow for the free flow of blood. Throughout this entire independent study, I realize that shadowing in the medical field is less about learning about medicine and more about discovering about whether becoming a doctor is the right step. This independent study has been a step in the right

The patient's comorbidities include Hypertension, hyperlipidemia, CAD, and GERD. The patient had a CABG operation a few days back from admission day on 4-10-2017. In addition to the CABG surgery, other procedures such as TEE, cardiopulmonary bypass, vein harvest, and a thoracotomy with a chest tube and JP drain. Significant surgical procedures also include angioplasty and left and right knee arthroplasty.

Events surround a recent total knee replacement surgical case performed by Dr. Smith may place the institution at risk for multiple tort claims. These claims involve the violation of operating room procedures and protocols, a post-operative medication errors, and an incident concerning the interaction between a member of the nursing staff and the patient.

In March of 2004, a doctor at the Wyoming Medical Center had been reported by one of the nurses for leaving an operating room during a surgery. Narotzky v. Natrona County Memorial Hosp. Bd. Of Trustees, 610 F.3d 561 (10th Cir. 2010). He had left Robert Griffin, a physician’s assistant, who had authorization to assist in surgeries but only under direct supervision of a physician. Id. After receiving the filed complaint, the Medical Center launched an investigation and eventually terminated a group of physicians. Id.

This proceeding before a Medical Review Panel, pursuant to La. Rev. Stat. §§ 40:1299.41, et seq., is brought by Jimmy Martinez against multiple health care providers, including Dr. Mark Kappelman, a qualified health care provider entitled to have the claim filed against him reviewed by this Panel. The claims made against Dr. Kappelman are mere allegations without support and proof. In a medical malpractice case the burden of proof is on the claimant to establish that Dr. Mark Kappelman’s actions in this matter fell below the standard of care required of similar health care providers. The claimant also bears the burden of proving whether any such alleged act or acts of negligence caused any injuries. It is the duty of the

In that situation, the negligence perpetrated by the anesthesiologist was an error—possibly an honest mishap or a consequence of carelessness but not deliberate or criminal. One of the primary reasons the patient’s sister filed the lawsuit was the absence of communication and information surrounding what happened when her sister was permanently injured. If the anesthesiologist and archdiocese had spoken honestly and openly to the patient’s sister, it might have safeguarded them from litigation. In this case study, the archdiocese and the anesthesiologist could have “come clean” from the beginning. They could have taken responsibility for their mistakes, apologized sincerely, and offered to financially and medically support the patient for the rest of her life. In turn, the patient’s sister may not have sued them, the anesthesiologist would not have covered up his mistake (thereby committing a criminal act), and the admitting nurse would still be a nurse.

The defendants maintained that the decedent’s symptoms were consistent with allergies; however, it is important to note that the decedent’s symptoms were reoccurring and had not responded to the initial prescribed treatments, thus prompting the provider to prescribe an additional course of antibiotic therapy as well as antihistamines and nasal sprays over the course of 9 months. Taking this into account, the non-response to therapy should have alerted the physician and the nurse practitioner that additional diagnostic testing should have occurred, such as sinus x-rays, a CT scan or MRI, which would have given the providers additional data. According to Michon (n.d.), a failed diagnosis or delay in diagnosing is not in of itself negligence;

When considering the legalities of this scenario, negligence, vicarious liability, and physician- patient relationship are a few components that affect the outcome of a lawsuit. The amount of legal torts that were violated in this case was enough to cause disputes between patients and healthcare staff. Negligence is a familiar tort that occurs much more than it needs too. Unfortunately in this case, vicarious liability and patient-physician relationship are two considerations that influence this case as well.

There are errors and hazards in care that occurred in the Mr. B scenario. One error was the emergency room physician’s failure to recognize the signs and symptoms of deep vein thrombosis (DVT) that Mr. B was presenting. If not treated early, a DVT can become a pulmonary embolism, a fatal condition that Mr. B unfortunately developed. Another error in care that happened in the Mr. B scenario is the nurses’ failure to monitor Mr. B’s ECG and respirations. Early detection of critical ECG and respiratory changes could have initiated medical interventions that would have saved Mr. B’s life. One hazard is the emergency room nurses’ heavy patient load at the time of Mr. B’s sentinel event. Another hazard is having a licensed

In the case study, there has been fraudulent activity in this office that would warrant criminal sanctions. There have been claims filed in which patients were seen by an NP but billed as though they had seen a physician, at times, even when that physician was not in the office that day. This is a

First he was negligent in the oversight of his resident physician, next he made a false statement when questioned by his employer, and lastly he altered medical documents that can be used if the case goes to trial (Pandit, 2009). In the Matter of Jascalevich1. It was held that a physician's duty to a patient cannot but encompass his affirmative obligation to maintain the integrity, accuracy, truth and reliability of the patient's medical record. Using this case we can affirm that the medical records are a part of the responsibility of a medical provider and in no circumstance will it be amended to benefit one’s self or other constituents. According to Pozar (2014) tampering with records sends the wrong signals to jurors, and can create a presumption of negligence. It is very clear that if this case goes to trial the physician is liable to face charges of medical malpractice, fraud and

The nurses noted unsafe and illegal practice by Dr. Arafiles and reported it to the medical board after the hospital board failed to investigate the concerns that had previously been reported by two staff physicians. The reporting of Dr. Arafiles was done by Mitchell and Galle with the intent to prevent additional patient harm by Dr. Arafiles.

appear similar to conventional stents.”8 Middleton, Teefey and Darcy8 note that the use of PFTE endografts will likely become standard as their performance outweighs the early stent materials used. Color Doppler as well as pulsed Doppler should be used to interrogate the stent and supporting vessels. Velocity measurements are taken using angle correct and spectral waveforms are recorded. Careful examination of the liver vasculature is imperative to verify proper stent function. Specifically, thrombosis or occlusion can be assessed with color and Doppler ultrasound. Velocity parameters may vary from patient to patient and also will change from immediate post procedure velocities to those obtained during long term follow up. Universal Doppler