Case Study

HSA  4553-­‐Legal  and  Ethical

Case  Law  I

Read  the  following  case  and  address  the  questions  that  follow  in  an  APA  formatted  paper.  Be  detailed  in   your  response.  Include  a  title  page  and  a  reference  page.  Minimally,  the  text  should  be  the  reference.

Patient   J.W.  presented   to   the  emergency  department  of  Community  Hospital  with  a   severe  headache   that   had   persisted   over   several   days.     Nurse   Jackie   was   assigned   to   care   for   J.W.     The   patient   was   exhibiting  a  number  of  signs  and  symptoms  that  would  have  indicated  that  blood  testing  and  a  head  CT   were   warranted.     The   patient   was   asked   by   the   triage   nurse   and   Nurse   Jackie   about   any   prior   neurological   issues,   persistent   headaches,   and   prior   cerebral   hematomas.     Even   though   she   had   a   history  of  all  of   these   things,   J.W.  was  a   little  disoriented   from  the  pain  and  denied  all  past  history   to   both  the  triage  nurse  and  Nurse  Jackie.

Nurse  Jackie  was  a  graduate  nurse  three  days  out  of  precepting  and  this  was  her  first  solo  shift.    Jackie   charted  the  symptoms,  but  did  not  understand  their  significance  or  call  the  physician.

Dr.   James,   the   attending   physician,   is   board   certified   in   family   medicine   and   is   a   member   of   the   Community   Hospital   medical   staff   with   emergency   department   privileges.     He   has   a   full-­‐time   family   practice,  and  only  fills  in  at  the  emergency  department  when  the  hospital  has  a  critical  need.    Dr.  James   worked  in  an  emergency  room  during  his  residency,  but  has  not  practiced  emergency  medicine  full  time   in  the  ten  years  since.

Dr.   James  rounded  on   J.W.  and  ordered  morphine   for   the  headache  and  no  other   tests.    Nurse   Jackie   administered  the  medication  as  ordered  and  documented  a  reduction  in  pain.    She  also  noted  that  the   other  symptoms  did  not  improve.

When  Dr.  James  rounded  again,  he  saw  that  the  pain  was  reduced  and  discharged  J.W.

Approximately   four   hours   later,   J.W.  was   rushed   back   to   the   hospital   by   ambulance   and   died   from   a   severe  brain  hemorrhage.


1. What  are  the  important  facts  of  the  case?

2. Are  all  the  elements  required  in  a  negligence  suit  present?

3. What  standard  of  care  is  required?

4. Who  would  you  consider  to  be  the  potential  plaintiff(s)  and  defendant(s)?

5. Who  would  the  plaintiff  allege  was  negligent?

6. What  evidence  would  you  present  against  each  defendant?

7. What  defenses  would  each  defendant  raise?

8. What  additional  information  would  you  like  to  know?



9. Who  do  you  think  is  responsible?

10. If  you  had  to  apportion  fault  by  percentage,  what  amount  would  you  assign  and  to  whom  would   you  assign  it?

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