Problem (pg. 55) “Bonnie Bowser, eighty-two years old, fell and severely injured her elbow. She was examined at the Emergency Department of the Miraculous Regional Health System and diagnosed with a fractured olecranon process, and referred to an orthopedic surgeon. The surgeon who examined Mrs. Bowser scheduled her for corrective surgery the next day. He noted in his examination that she had a past medical history of hypertension, diabetes mellitus, two myocardial infarctions with quadruple bypass surgery, and a cerebrovascular accident affecting her left side. She was taking several medications including Lasix (a diuretic), Vasotec (for treatment of hypertension and symptomatic congestive heart failure), Kylotrix (potassium supplement), …show more content…
Standardization is key in hospitals and clinics alike. If a high risk patient such as Bonnie is admitted into an emergency room for a fractured elbow, all of her options should be explained to her. Corrective surgery would be a great option but she needs to be aware of all the risks associated with this procedure and any outcome that could occur. I’m sure if she was told that it is not recommended for someone at her old age or poor health status to undergo surgery, she would have taken more time to think about it. Something this serious should be discussed with family before going through with the procedure. This adverse event should be escalated properly so that the administration and other doctors are aware of the outcome. This death could have been prevented, and others should be able to learn from this. We don’t know the full story from this short problem described in the book, but many questions arise from the situation. Was she completely aware of the risks? Did she know she was not a good candidate for the surgery? Question 2: What system-wide rules will you propose to avoid a repetition of such cases, as the head of your state’s Department of Health? Spearheading from the last question, the regulatory categories pertain to this as well. The provider is responsible for putting the patient’s welfare above anything else, and system-wide rules should
Medical error is the third leading cause of death in the US, right behind heart disease and cancer. More than 200,000 people die annually as a result of diagnostic mistakes and negligence by healthcare professionals (Washingtonpost, 2016). In the healthcare industry, even the smallest mistakes and oversight could lead to severe consequences for both the patient and professionals. A healthcare professional would be held liable for any discrepancies that causes harm. The following case will analyze the ethical issue and negligence that lead to the death of an elderly woman.
There are several features to the case of the burned patient which could leave the doctor culpable in a court of law. Given the high probability of infection from the operation and her already-compromised vision in the right eye, the doctor's actions in advising her to elect surgery seem extremely unwise. The patient specifically inquired about the risks of the procedure and the physician said there was nothing to worry about, which a layperson would be very likely to interpret as no risk at all (as the patient did). He did not inform her of the high risk of infection which, based upon the presentation of the case study, seems to be a widely-known risk of the procedure in the medical community.
The initial problem with Lewis Blackman's case was that lewis was administered inappropriate medication. First he was given a strong dose of opioid pain medication and on top of that prescribed an adult IV painkiller called Toradol. His medication was being increase even though it was not affecting the patient relieve pain. The nurses fail to diagnose the patient's pain and reevaluate him on his pain status. Followed by that Lewis was having trouble breathing, that is one of the first priorities for a nurse. Yet they assume because he had a history of asthma, him having affected breathing was normal. Therefore, his vital signs, pulse oximeter, were compromised the day after surgery from 90 to 85 which is low. The hospital was not concerned
History: Margaret Donovan, a 72-year-old white female, was brought to the emergency room by her son-in-law after falling in her bathtub. She was previously in good health, despite leading a relatively sedentary lifestyle and having a 30-pack-year history of cigarette smoking. The only medication she currently takes is Inderal (propranolol) for mild hypertension. She fell upon entering the bathtub when her right leg slipped out from under her; she landed on her right hip. There was no trauma to her head, nor does she complain of right or left wrist pain. However, she reports severe pain in the right hip and upper thigh, and was unable to get up after her fall. An injection
treatment and if any specialty agency would need to be contacted. Ignoring these regulations can cause damage that is un-repairable.
this type of care provision is required by law and is governed by the legislation. Local and health authorities like the NHS are all subject to the laws of the land in delivering services and meeting targets that are set, the targets are set so that the people in the country follow them. The care provision is to last until the patient has entered the hospital and is healthy enough so that they don’t need help anymore. The positive side of this is that
A nurse attending stated “during the morning’s second surgery, he actually dozed off. The nurse took him aside and recommended that he take a break, but he refused and returned to the operation.” The nurse here was in fault in more ways than one. This nurse should never allowed the doctor return back to operate on the patient, he should have been removed from the operating room immediately. The nurse should have
Charlies doctors acted unethically when they asked if Charlie wanted to do the operation. The doctors didn’t ask Charlie these questions. "Has the patient been informed of benefits and risks, understood this information, and given consent? Is the patient mentally capable and legally competent, and is there evidence of incapacity? If mentally capable, what preferences about treatment is the patient stating? If incapacitated, has the patient expressed prior preferences? Who is the appropriate surrogate to make decisions for the incapacitated patient? Is the patient unwilling or unable to cooperate with medical treatment? If so, why?"(Siegler). The doctors just told Charlie that the operation will make him smarter. This was very unethical by the doctors who kind of took advantage of Charlie just for research.
One of the reasons the doctors were not ethical is they didn't tell him all of the risks and he didn't really understand what was going to happen after the operation. ''Miss Kinnian says maybe they can make me smart.''(Flowers for Algernon progress report 1 March 5 1965) ''Has the patient been informed of benefits and risks, understood
Pharmacists are the only professionals excluded from provider status that nearly every ill and/or healthy patient could
When the doctor said she didn’t have an infection, but why was Maya having such difficulty breathing? The doctor told Maya’s parents that he would like to perform a BRONCHOSCOPY the following morning. He explained to Maya’s parents this would give him a better look down Maya’s throat and airway to see if anything is wrong or obstructing it. Jana was hopeful they would maybe get some answers, but there was only one problem she had BARIATRIC SURGERY scheduled for the next morning. She had been working for this surgery for over a year, she lost 250 pounds just so she would be a candidate. Now she had a tough decision to make.
Another statement that I agree with is whether you are too young or too old, you should receive the same care. In any circumstances, a physician should never discriminate of age. If a young and an old person has the same injury, the physician should provide proper care to both patients. If
25). Unfortunately, the article regarding Mr. Benson’s case did not give detail on whether or not proper documentation had occurred. However, one can assume documentation was not done properly as the wrong leg had been amputated. If proper documentation had been completed in Mr. Benson’s case, it is possible someone besides the surgeon may have caught the wrong leg was about to be amputated. An example of proper documentation would be the consenting of the patient for surgery. Mr. Benson had to have been consented for surgery, which means a doctor or a nurse practioner would discussed with the patient which leg was to be amputated, signs and symptoms of complications and what to expect after surgery. If there was any question once the patient was in the operating room, which leg to amputate, anyone could have looked in the patient’s chart to see what Mr. Benson had been consented for. Documentation of the time out could have also prevented Mr. Benson from having the wrong leg amputated. The reason being is, everyone involved in the case would have stopped and made sure the right patient was in the operating room and the right surgery was to be performed so it could be documented this act was completed. Not only proper documentation could have prevented this horrible act but also the help of the nurses could have prevented a mistake like this from happening.
Olecranon fracture is a common injury and constitutes 10% of upper extremity fractures (1, 2). It commonly occurs due to a direct impact or a fall onto an outstretched hand. Management of olecranon fractures with tension band wire fixation is indicated in simple displaced fractures and was first introduced by Weber and Vasey in 1963 (4). There is a high prevalence of metalwork removal due to metalwork irritation. Metalwork irritation may be caused by Kirschner-wires loss of fixation and backing out of the insertion site (5).
S.P. is admitted to the orthopedic ward. She has fallen at home and she has sustained an intracapsular fracture of the hip at the femoral neck. The following history is obtained from her: She is a 75-year-old widow with three children living nearby. Her father died of cancer at age 62; mother died of heart failure at age 79. Her height is 5’3 and weighs 118 pounds. She has a 50 pack year smoking history and denies alcohol use. She has severe Rheumatoid Arthritis (RA) and had an upper GI bleed in 1993 and had Coronary Artery Disease with CABG 9 months ago. Since that time, she has engaged in “very mild exercise at home.” Vital signs are 128/60, 98, 14, 99 degree farenheight (32.7 degrees C) SAO2 94%