Application: Legal and Ethical Issues of a Medical Error Case

Health care providers are fallible and will make mistakes. Unfortunately, these errors can sometimes have dire consequences for patients, and the providers, as well as the organizations, may be held liable for the harm that resulted.

In this Application Assignment, you will analyze a case study of medical error for its legal and ethical implications, and propose ways that a health care administrator might help prevent this kind of error from happening.

Review the scenarios of medical errors in the following readings from this week and select one of them to focus on in the paper.
1.Gallagher, T. H. (2009). A 62-year-old woman with skin cancer who experienced wrong-site surgery:
Review of medical error. JAMA: Journal of the American Medical Association, 302(5), 660–5 77.
2.Part 1, “Understanding the Causes and Costs of Medication Errors,” pp. 43-45 (Case on the death of the day-old infant), Preventing Medication Errors: Quality Chasm Series (2007), http://books.nap.edu/openbook.php?record_id=11623&page=43.
3.Rosenthal, K. (2004). “Where did this patient’s I.V. therapy go awry?” Nursing, 34(5), 56-57.

Prepare for the paper by considering the following:
•What laws were, or may have been, broken in this case, and by whom? Did you agree with the assessment of liability (if any) provided in the scenario? Why or why not?
•What are the main ethical issues of this case?
•Health care providers are sometimes reluctant to admit wrongdoing, provide full disclosure, or apologize to the victim or family, or they are advised not to by legal counsel, risk managers, or others. Reflect on the discussion in the JAMA article about disclosing errors to patients and families. What are some of the legal and ethical implications of disclosing errors in your selected case?
•What lessons could a health care administrator take from this case? Consider the role of the administrator in establishing and monitoring policies and setting the tone for the organization. Are there ways in which an administrator might help to prevent these kinds of errors from happening?

The Application Assignment:

With these thoughts in mind, write a 3- to 4-page paper in which you address the following questions:
•Summarize the legal aspects of this case. Identify the laws that were, or may have been, broken. Who was, or may have been, liable?
•Did the provider fail in any way to adhere to ethical standards? How might this have impacted the patient outcome?
•If noted in the scenario, how did the provider interact with the patient or family after the error came to light?
•Discuss the pros and cons of having the provider disclose and apologize for the error to the patient or family soon after the occurrence. What are the legal and ethical implications of this approach? In general, how might this approach impact the physicians, nurses, technicians, or others who may have contributed to a medical error that harmed a patient?
•In what ways can health care administrators help prevent the kind of error described in the scenario from happening in the first place? How can they assist the providers and organization after such an error occurs?

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Roadmap
Policy: Improve Health for Specific At-Risk Populations
Specific populations that are at risk for poor health outcomes
for manageable conditions present unique opportunities for care
improvement. Toward this end, the Task Force recommends that the
targeted interventions detailed below be implemented to address the
special health care needs of specific sub-populations. Strategy
Element #15: Expand the existing evidence-based family home
visiting program for high-risk mothers and evaluate the impact of
home visiting on health disparities. Minnesota children who
experience economic hardships, maltreatment, and other trauma face
distinct risks to their overall health and development. In
Minnesota, 13.7% of pregnant women received inadequate or late (2nd
or 3rd trimester) prenatal care, 15.2% of pregnant women smoked
during their pregnancy, and 4.3 per 1,000 children 12 years and
younger are abused or neglected.
Evidence-based family home visiting has been shown to be an
effective service strategy for very young children and their
families, improving outcomes in lifelong health and well-being,
school readiness, and economic self-sufficiency.
Research-based family home visiting models have proven that for
every public health dollar invested, a return of up to $5.70 can be
expected in savings to programs including Medicaid and food
support. Therefore, the Task Force recommends expanding the family
home visiting program to include voluntarily-enrolled first-time
mothers on Medicaid and pregnant and parenting teenagers in the
Minnesota Family Investment Program (MFIP).
After reading the Road Map to a Healthier Minnesota, pick a
policy you want to discuss further in this discussion board.
What did you find most surprising in the plan and the
policy?
Discuss the implications the healthcare policy you chose impacts
the healthcare crisis happening today.
Perhaps the policy suggestions in the report are not something
you encounter in your work or profession. If not professionally,
which policy change recommendations resonate with you as a citizen?
Support your ideas with examples you have experienced and
information you have read which bring you to a place of passion (or
compassion!) for one or more of the recommendations.

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