- Introduction:
Summarize the case
Iturralde v. Hilo Medical Center case
Iturralde v. Hilo Medical Center case was decided on March 30, 2012, by Hawaii’s Intermediate Court of Appeals. The stakeholders involved in this case include Arturo Iturralde and Rosalinda (plaintiff) and Hilo Medical Center, and Dr. Ricketson (defendant). The critical problem being decided on involves medical malpractice. In January 2001, Artuto was admitted to HMC with frequent falls and bilateral legs weaknesses. On 24th January, Dr. Ricketson examined Arturo and diagnosed him with stenosis. Arturo was then booked for a spinal fusion surgery the next day morning. Lacking the necessary rods to be implanted into the spine, the hospital ordered from Medtronic. The instrumentation portion of the kit was not received by HMC, making it to outsource. An Inventory was forgone when the equipment arrived, and despite this awareness, Dr. Ricketson commenced the surgery. The rods were not located at the critical stage when the surgery was underway, and upon inquiry, they were to be delivered within ninety minutes. Dr. Ricketson couldn’t wait and improvised rods that lacked approval for human use. The patient was then discharged without being informed of what happened and was instructed to do weekly therapies. The rods would then rapture when Arturo fell, and corrective surgery was required. Dr. Ricketson would then replace the fractured screwdriver shaft with the correct rods. A report of what happened was made to the supervisor by Felmeyer, who was present during the operation. Still, the supervisor declined to inform the patient arguing that it was the doctor’s responsibility. Feldmeier secretly presented evidence to the lawyer. Meanwhile, Arturo was discharged, and his condition deteriorated. The titanium rods were dislodged, and two further corrective surgeries were done in Honolulu. Arturo later succumbed on 18th June due to urosepsis complications.
- Medical Malpractice Component: In this section, you will evaluate the case to address the legal components, the malpractice policies similar to this case, and the standard of care given to the patient and how it was breached. Then, you will draw connections to how this malpractice case impacted
stakeholders and healthcare consumers outside of the case.
Key Legal Components of The Case
The appellant raised claims pointing to negligence, the negligence credentialing, the breach of warranty, and strict liability against the defendants. Also, the appellant raised two claims of negligence and negligence credentialing against Hawaii Orthopedics, Inc., which is a non-party stakeholder and an employer of Dr. Ricketson. The jury trial covered February 6th to March 13th the year 2006. According to the HRS 662–5 (1993), the Jury was employed by the circuit court to serve in an advisory capacity on claims against the hospital.
Dr. Ricketson was under professional obligation and legal duty to provide care in conformity with the set professional standards guiding his service area as a surgeon. Professional conduct implies that Dr. Ricketson was not expected to implement a decision that would have grievous consequences to the patient’s health. The Doctor practiced professional and legal negligence by going on with the surgery before confirming the availability of all necessary equipment and using an improvised rod not authorized for human use.
……………..observed that physicians are held in an ethical dilemma on how to act when confronted by different situations and are often confused on which option is ethically appropriate to alleviate patient’s pain and suffering. This, therefore, indicates that Dr. Ricketson could have considered waiting for the appropriate rods for ninety minutes to be risky to the patient’s life. The Doctor’s resolve to use unauthorized improvised rods while is believed to have aggravated the situation and led to the patient’s death was intended to help and not harm the patient.
Relevant Malpractice Policies
The malpractice policies that would help address the case’s issue include the negligence policy, the negligent credentialing policy, the warranty policy’s breach, and the policy on strict liability against the defendants.
The medical negligence policy stipulates that there must be proved beyond a reasonable doubt that substantive medical care advanced to a patient resulted in any form of injury for the validity of a malpractice claim based on professional negligence. Negligent credentialing requires a demonstration by the injured patient that the medical facility subverted its duty of due care desirable for the credentialing process or election to grand the doctor staff privileges. The injured patient must also demonstrate that the doctor acted in negligence when advancing care. Lastly, the patient must prove the hospital’s negligent credentialing to be a proximate cause of patient injuries. The breach of warranty policy would be considered to rule on whether the doctor’s failure to exercise his skills to a certain desirable degree resulted in the patient’s injury. On the other hand, policy on strict liability holds the physician responsible for the consequences of his or her actions regardless of the intention.
Standard of care provided
Patients are obliged to receive a reasonable standard of care. A patient has a right to information on material risks to determine if to consent to treatment. In our case, this provision was denied. The Doctor concealed treatment information from the patient, and neither was the patient’s input sought in the making of the treatment decision. The law requires treatment provides to a patient to align with scientific evidence. This again was not the case as the Doctor chose to use an improvised rod that lacked medical approval for human use. The law also stipulates that the physician’s failure to provide treatment that aligns with the standard of care would make him or her legally liable in case of injury or death. Given the patient incurred injuries and death as a result of substandard care, it, therefore, follows without objection based on this analysis that the Doctor must be held legally liable.
Impact on healthcare consumers
Individuals of different cultures have similar expectations on the standard of care. Laws on the standard of care and professional integrity are mutually binding across cultures. Therefore, the evidence shown in this case would have a similar impact on individuals from different cultures. In general, healthcare consumers would be skeptical about the quality of care systems. This case would result in low trust and confidence ratings in the healthcare system. That a healthcare system can cause injuries and death in complete disregard to professional standards is an issue of greater concern whose mitigation is necessary to reviving trust in the care system.
Accountability; a healthcare provider
The health provider’s individual degree of negligence was determined to be over 25 percent, and thus joint and other several damages were awarded against HMC, thus complying with the HRS § 663–10. 9(3). I consider the determination of holding the care provider severely accountable and liable for its role in the malpractice both sound and fair.