HRM FPX 5401 Assessment 4 Malpractice: Advisory Report

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Capella University

HRM-FPX5401 The Legal, Ethical, and Regulatory Environment of Health Care

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Date

Vila Health Malpractice Advisory Report

Introduction

This advisory report aims to provide Vila Health with strategies to prevent medical malpractice and guidance on how to respond if such situations arise. Medical malpractice is defined as any act or omission by a physician during patient treatment that deviates from accepted medical norms and results in patient injury (Baker & Smith, 2009). To mitigate the risk of malpractice claims, Vila Health must develop a comprehensive strategy that includes implementing safety and risk control protocols. Establishing effective communication, surveillance, and fostering a safety-focused culture are essential steps. By adhering to these practices, Vila Health can enhance security, reduce malpractice claims, and improve legal management.

Summary of Researched Malpractice Cases

Two Different Medical Staff Roles Resulting in Litigation of Malpractice

Surgeon Malpractice:

The field of spinal neurosurgery is particularly susceptible to litigation due to the complexity of the conditions treated, the proximity of instrumentation to critical neurovascular structures, and the delicate nature of the spinal cord and nerve roots (Zachary, 2020). Research indicates that approximately 20% of practicing neurosurgeons in the United States face medical malpractice litigation annually, with the average indemnity for closed neurosurgical civil claims reaching $439,146, the highest among medical specialties (Collins, 2020).

One notable case involved a Philadelphia neurosurgeon who performed decompression surgery without obtaining necessary radiology tests, resulting in permanent injuries to the patient. The surgeon failed to secure flexion/extension X-rays, which would have identified the patient’s unstable spondylolisthesis. This negligence led to three subsequent surgeries and left the patient with an unstable spine. Eventually, the patient sought care from another physician who corrected the initial surgeon’s errors (Feldman, n.d.). The primary issue stemmed from inadequate preparation and a failure to adhere to the standard of care. To prevent such mistakes, surgeons must undergo proper training, follow established protocols, and execute procedures in accordance with medical standards. The practices and policies in place during this malpractice case likely contributed to insufficient preoperative planning and assessment, resulting in ethical failures.

Prior to the procedure, the medical staff neglected to conduct a thorough patient assessment, which is crucial for developing an appropriate care and treatment plan. Inadequate assessments can lead to misdiagnosis and subsequent patient injury (Pozgar, 2020). The failure to order the necessary X-rays not only posed legal risks but also resulted in a $2 million settlement for the physician and the hospital.

Nurse Malpractice:

Nurses can also face lawsuits for medical malpractice or negligence based on their actions or inactions. Case studies reveal that approximately 18% of closed medical lawsuits from 2018 to 2021 involved registered nurses (RNs), licensed practical nurses (LPNs), nursing assistants, and nursing students. Common allegations include failure to monitor patients, medication errors, patient falls, and pressure injuries (Gay, 2023).

In one case, a nurse administered medication to a patient complaining of pain three times without checking vital signs. By the fourth check, the nurse discovered that the patient’s condition had deteriorated significantly. Upon checking vital signs, the nurse found the patient’s temperature had dropped to 95.8°F. At this point, the patient was cyanotic, had stopped breathing, and had no pulse. A code was called, and CPR was initiated. The CPR team successfully revived the patient with epinephrine, but the patient spent two weeks in the ICU in a comatose state. Subsequent MRIs revealed brain damage due to oxygen deprivation, resulting in permanent and severe cardiopulmonary arrest and hypoxic brain damage (Pozgar, 2020).

Contributing Factors to Negligent Nursing Care

The practices, policies, and systems in place in this case likely contributed to the failure to adequately monitor the patient for signs of distress and to respond promptly, resulting in a lack of reasonable quality of care. This negligence is characterized by a nurse’s failure to meet the minimum standards of nursing care, which can lead to harm or loss. Negligence may arise from either the failure to perform a nursing duty or from executing a nursing task incorrectly (Darner, n.d.). Vital signs assessment is a crucial aspect of acute clinical care, representing the simplest yet most significant data collected from hospitalized patients. Neglecting to assess these vital signs can place patients at risk, as clinical deterioration may go undetected or be recognized too late for effective medical intervention (Malone, 2022). The failure to adhere to established policies and procedures for monitoring vital signs had severe repercussions for both the nurse and the hospital, culminating in a $9 million settlement awarded to the patient.

Recommendations to Avoid Future Litigation

Organizations continually face various internal and external risks. In response, human resources (HR) must develop and implement strategies to prevent and mitigate risks and adverse events, thereby minimizing harm to the organization and its employees (Society for Human Resource Management, n.d.). HR professionals in healthcare are responsible for ensuring compliance with numerous safety, privacy, training, and regulatory policies. To proactively avoid litigation, HR should ensure that the organization adheres to a range of industry laws, including the Health Insurance Portability and Accountability Act (HIPAA), which protects patient data; the Emergency Medical Treatment and Labor Act (EMTALA), which mandates that hospitals treat all patients arriving at emergency rooms regardless of their ability to pay; the Patient Safety and Quality Improvement Act (PSQIA), which protects healthcare workers who report medical errors and unsafe conditions; and the Health Information Technology for Economic and Clinical Health Act (HITECH), which promotes the use of technology to enhance healthcare quality, safety, and efficiency. By following these required policies regarding treatments and protocols, healthcare organizations can significantly reduce the likelihood of future litigation.

Benefits to the Organization and Patients

Implementing these best practices offers numerous benefits for both the organization and its patients. A key element in avoiding malpractice claims is fostering a healthy doctor-patient relationship, which relies on clear and effective communication. This approach helps build patient trust, thereby reducing exposure to malpractice litigation and its associated costs, protecting the organization’s reputation, and maintaining financial stability. For patients, this leads to a higher standard of care and minimizes the risk of medical errors. Establishing strong doctor-patient relationships and adequately preparing for each patient’s individual needs and concerns can mitigate malpractice risks, ensuring that patients feel safe and valued.

Ethical and Legal Considerations

The recommended approach is both ethical and legal. Operating within compliance emphasizes thorough screening, ongoing training, and effective communication, fostering a culture of safety and accountability. The legal framework is defined by laws, rules, and regulations that require mandatory adherence. Implementing these requirements compels the organization to make ethical decisions that align with its values. By focusing on these aspects, the organization takes legal steps to prevent potential malpractice cases and maintain compliance with healthcare regulations. In conclusion, lawsuits for medical negligence can be minimized or avoided by ensuring patient satisfaction, adhering to policies and procedures, developing patient-centered care, and understanding how to defend against malpractice claims (Collins, 2020).

References

Collin, J. L., Larkin, C. J., & Roumeliotis, A. G. et al. (2020, November). Overview of medical malpractice in neurosurgery. Retrieved from National Library of Medicine: https://pubmed.ncbi.nlm.nih.gov/33130621/#:~:text=Annually%2C%2020%25%20of%20all%20practicing,highest%20of%20all%20medical%20specialties.

Endacott, M. E. (2022, August 10). The clinical neglect of vital signs’ assessment: An emerging patient safety issue? Retrieved from https://www.tandfonline.com/doi/full/10.1080/10376178.2022.2109494

Faubion, D. (n.d.). 20 most common examples of negligence in nursing and how to prevent them. Retrieved from 20 Most Common Examples of Negligence in Nursing + How to Prevent Them.

Feldman Shepherd Wohlgelernter Tanner Weinstock Dodig LLP. (n.d.). $2 million spinal surgery case against neurosurgeon and hospital settles. Retrieved from https://feldmanshepherd.com/results/2-million-spinal-surgery-case-against-neurosurgeonand-hospital-settles/

Morris, G. (2023, March 2). Can a nurse be sued for malpractice? Retrieved from https://nursejournal.org/articles/can-a-nurse-be-sued-for-malpractice/#:~:text=The%20review%20of%20medical%20malpractice,death%2049%25%20of%20the%20time.

Pozgar, G. D. (2020). Legal and ethical essentials of health care administration (3rd ed.). Burlington, MA: Jones & Bartlett Learning.