You are responding to another students original discussion board post. These are the instructions of the original post:

Topic: Negligence and Medical Malpractice

View the assigned Healthcare Law LearnScape interactive episode in the Jones & Bartlett website (DB2 LearnScape Case Study). You will be presented with a negligence case stemming from an incident in the hospital. You must interview staff members and work with the General Counsel to determine the hospital’s liability for negligence and medical malpractice.

Prompt: Based on the information you gathered from the LearnScape video interviews, on your research, and on a biblical worldview, analyze this incident and write your recommendation to the Chief Counsel regarding negligence/malpractice liability. Directly address the 4 elements required to prove negligence:

1. Duty to care
2. Breach of duty
3. Injury
4. Causation (specifically foreseeability)

Upload a Word document copy of the post into SafeAssign for plagiarism review; then, copy and paste the content into the Discussion Board Forum (do not post with attachments). Title your thread “Liable” or “Not Liable” to reflect your conclusion.

Reply prompt: Respond to threads posted by 2 classmates who reached a different conclusion than you did. Identify the points of difference in your analyses and explain how your sources and analysis led you to your conclusion.

Here is the post you are replying to:

Mrs. Smith had been admitted to the hospital for surgery and post-surgical care. During her stay, Dr. George Paltrow, along with residents, examined her and the other three patients in the post-surgery patient center. While examining the patients, Dr. George Paltrow, nor the residents, changed gloves or washed their hands in between examining each patient. Mrs. Smith was the last patient to be examined. After examining Mrs. Smith, Dr. George Paltrow and the residents disposed of their gloves in the garbage and washed their hands less than five feet away from Mrs. Smith’s bed.This had been confirmed by the treating pulmonologist Dr. Holly Brigham. The pleural space had been drained from the excess fluid, and an infectious disease specialist began aggressive antibiotic treatments. Mrs. Smith’s hospital stay was extended from 5 days to 30 days while she battled the staph infection. During her stay, Mrs. Smith contracted a staph infection, which entered her blood stream and resulted in empyema in her left lung. It has been confirmed that the first patient examined by Dr. George Paltrow and the residents had staph infection. Each patient in the room has received the staph infection due to their exposure. The nurses on duty failed to have contacted Dr. George Paltrow when they suspected that Mrs. Smith had contracted an infection. The severity was known among the nurses, since they offered to have a priest come talk to Mrs. Smith. Mrs. Smith was able to receive the care needed to combat the staph infection due to her husband, Mr. Smith contacted a CEO, who helped provide the necessary tests and care for his wife to recover. Mrs. Smith and her husband are suing the hospital for negligence for the infection she received and then the autoimmune condition she got from the infection. After the incident, the hospital increased hand hygiene signage and made protocols better known throughout the facility.

Duty of Care and Breach of Duty

Duty of care is the “ legal obligation of care, performance, or observance imposed on one to safeguard the rights of others” (Pozgar, 2019,p.44). The relationship existing sets the standard of caregiver-patient relationship (Pozgar, 2019). Since Mrs. Smith had been admitted to the hospital for surgery and post-surgical care, the duty of care between the patient, the hospital, and it’s doctors has been established. Under this relationship, a contract is formed ( Pandit & Pandit, 2009). In this contract the doctor, staff, and hospital owe certain standard duties to their patient, and any breach of those duties provides cause of action for negligence ( Pandit & Pandit, 2009).

Breach of duty is defined as the “ failure to conform to or the departure from a required duty of care owed to a person. The obligation to perform according to a standard of care can encompass either performing or failing to perform a particular act” (p.50). Since Dr. Paltrow and the residents failed to change gloves and practice standard hand hygiene, the failure of the nurses to properly notify Dr. Paltrow, and the failure of the hospital to make standard policies known, as well as their failure to provide boxes of gloves in each patients room and adequate access to handwashing sinks establishes breach of duty in this case. It was well-known among staff that there was a lack of training and protocol signage, as well as inadequate supply of gloves in the room or convenient washing station outside the rooms to allow for proper protocol. The hospital is then considered negligent not only for their actions but for the actions of Dr. Paltrow and the nurses on duty. This is due to respondeat superior , where an employer is legally responsible for its emp0loyees negligent acts ( Thornton, 2010). “ The underlying premise of respondeat superior is that the cost of torts committed in the conduct of a business enterprise should be borne by the enterprise as a cost of doing business” ( Thornton, 2010). Under this, the business has the right of control of details and the manner in which the employee performs their job ( Thornton, 2010). In this case, practicing basic hand hygiene, changing of gloves, and notifying the proper attending.

Injury

Dr. Holly Brigham was the attending pulmonologist that was brought in after Mrs. Smith had contracted the staph infection. She stated that the staph infection had to have been passed through direct contact with the non sterile gloves and the incision. From there, the staph entered the bloodstream and continued to spread to the left lung. This resulted in empyema. The fluid then had to be drained from the pleural space and an aggressive antibiotic treatment had to have begun. The patient was left with a permanent pocket of sterile encapsulate fluid in the lung’s pleural space. This, however, is not uncommon and helps to ensure that the infection would not return in the future. Dr. Holly Brigham was unsure if this could have led to future illness, such as the autoimmune disease Mrs. Smith is claiming to have received it due to the infection.

Causation

Causation is an element that must be proved inorder to consider negligence actionable ( Turton, 2009). For causation to be proved factual and to be established, it must be shown that if the defendant’s negligent actions had not occurred, the harm would not have occurred ( Turton,2009). If the harm would have occurred even in the absence of negligence, then the defendant cannot be liable ( Turotn, 2009). In this case, various sources, including lab work, has identified that the staph infection Mrs. Smith obtained while in care came from the transfer of the infection through non-sterile gloves that were used to examine the first patient in the post-surgical recovery center. Mrs. Smith would not have obtained the staph infection if proper cross-contamination and hand hygiene had been observed by Dr. Paltrow and the residents who examined each of the four patients in the post-surgical recovery center. Proper protocols and procedures were not established, known, and enforced by the hospital, causing the cross-contamination and further prolonged experience to occur to Mrs. Smith

Conclusion

Galatians 6:9 states “ And let us not grow weary of doing good, for in due season we will reap, if we do not give up”. Doing right in this case, is observing and making right the negligence that occurred causing Mrs. Smith’s actions.Since Mrs. Smith had been admitted to the hospital for surgery and post-surgery care fulfills the establishment of duty of care. Mrs. Smith not only contracted the staph infection while under the care of the hospital, but had such a prolonged experience due to staff’ actions is proof that the duty of care was breached during her stay. Dr. Paltrow and residents were witnessed not changing gloves or practicing standard hand hygiene when examining the patients in the post-surgery patient care center. This passed the staph infection from the first patient to the other three, including Mrs. Smith. This transfer caused the staph infection to enter Mrs. Smith’s bloodstream and spread to her left lung, resulting in empyema. The lack of standard care by Dr. Paltrow, the failure of the nurses to notify Dr. Paltrow of the suspected infection, and the hospital not providing glove boxes in each patient room, as well as, the failure of adequate handwashing sinks outside of patients’ rooms has led to negligence liability and Respondent Superior since the individuals involved are employees.

Reference List

Pandit, M. S., & Pandit, S. (2009). Medical negligence: Coverage of the profession, duties,

ethics, case law, and enlightened defense – A legal perspective. Indian journal of

urology : IJU : journal of the Urological Society of India, 25(3), 372–378.

https://doi.org/10.4103/0970-1591.56206

Pozgar, G. D. (2019). NVPMD: Legal aspects of health care administration. 13E-Liberty

Custom. Burlington, MA: Jones & Bartlett.

The Holy Bible: New International Version. (2005). Grand Rapids, MI: Zondervan.

Thornton R. G. (2010). Responsibility for the acts of others. Proceedings (Baylor University.

Medical Center), 23(3), 313–315. https://doi.org/10.1080/08998280.2010.11928641

Turton G. (2009). Factual and legal causation — their relation to negligence in nursing.

British Journal of Nursing, 18(13), 825–827.