Introduction
A patient who approaches a doctor expects quality health care and medical treatment with the application of a healthcare provider’s all knowledge and skills for appropriate outcomes. At the same time, clinical personnel is responsible for beneficence and non-maleficence concerning patients who should be protected from any harm caused by clinicians’ reckless attitude, carelessness, or negligence. In general, medical negligence is defined as a medical practitioner’s act or failure to act (omission) that substantially deviates from commonly accepted medical standards and causes a patient emotional, physical, or financial damage (Shali, 2017). All healthcare providers involved in a patient’s treatment enter a particular doctor-patient relationship and are legally responsible for the consequences of medical negligence if it occurs. However, the fact of medical negligence should be established based on its obligatory characteristics. Thus, the purpose of this work is to reflect on the case, identify negligence if it has occurred, and responsible parties.
Background
In the case under analysis, Kay Chee, an 83-year-old retired taxi driver, had an appointment for tomography at Queen Mary Hospital on May 19, 2016. Subsequently, he required the procedure of dialysis at the facility’s intensive care unit which was conducted inappropriately. On May 27, the unit’s nurse responsible for dialysis unplugged Kay’s dialysis tube “without following instructions while the patient’s body was in the wrong position” (Hui & Shum, 2021, para. 3). To be precise, Kay Chee was supposed to lie, however, he was sitting during the procedure (Hui & Shum, 2021). Three days later, the patient died as his condition was constantly deteriorating. However, according to the patient’s autopsy report, acute myocardial infarction was a fatal condition and the direct cause of his death. That is why after long-lasting deliberation, the five-member jury ruled that a former taxi driver died by misadventure.
Along with a verdict, jurors provided several essential suggestions to avoid misconduct in medical facilities and raise clinicians’ awareness related to patients’ health conditions. They include the improvement of reporting procedures, the increase of the intensive care unit manpower, reviewing of a patient’s previous history and risk assessment, and training for nurses. At the same time, not all members of Kay’s family were satisfied with the court’s decision – his daughter-in-law refused to accept the absence of the nurse’s guilt in Kay’s death and insisted on the presence of medical negligence.
Problem Statement and Its Rationale
As a matter of fact, in the case of medical misadventure, a patient’s death is caused by medical negligence or an accident. From a legal point of view, medical negligence is a particular type of medical misconduct that possesses several specific characteristics that should be defined by a court to conclude that it has occurred. They include the presence of the duty of care, its breach, and this breach’s direct cause of a patient’s damage. In other words, to establish the fact of medical negligence and form a legal claim, law enforcement investigation should approve that a health care provider and a patient were bound by a legal doctor-patient relationship that presupposed a duty of care, this duty was breached, and a provider’s actions have directly led to a patient’s injury. The investigation may be regarded as highly essential as it determines the presence or absence of legal prosecution.
Analysis and Evaluation
To identify the existence of negligence and the expediency of the court decision, it is necessary to implement the plan of the analysis of a nurse’s actions based on the law to detect misconduct. In the case of Kay Chee, a duty of care was owed to a patient by the nurse who controlled the procedure of dialysis. A duty of care is obligatory and implied when a patient enters and registers in a hospital to receive treatment. Thus, all medical specialists responsible for a particular patient’s diagnosis, treatment, and health care are covered by a duty of care to this person (Adejumo & Adejumo, 2020). In addition, according to the most extreme view, healthcare providers owe a duty of care to all patients in a medical facility even if these clinicians are not directly involved in any intervention. Thus, they are legally responsible for medical negligence if it occurs.
At the same time, the breach of a duty of care by a nurse has been detected as well. According to commonly accepted standards of care, during the procedure of dialysis, the patient should be in a lying position. However, Kay Chee was sitting, and this fact was ignored by the nurse (Hui & Shum, 2021). In addition, the dialysis tube was unplugged without following instructions, it also demonstrates the health care provider’s omission. Finally, in the case of medical negligence, this breach should directly cause the patient harm. However, the patient’s death was the outcome of acute myocardial infarction (Hui & Shum, 2021). Those individuals who require dialysis due to advanced kidney disease are particularly vulnerable to cardiovascular complications (Cozzolino et al., 2018). That is why the likelihood is great that Kay’s infarction was caused by his chronic illness. However, there is no evidence that it was the nurse’s mistake that directly led to the patient’s death. This fact explains the decision of jurors who decided that there was no criminal negligence or violation of law related to the patient’s death.
In the case of medical negligence committed by health care providers that resulted in a patient’s injury or death, a hospital may be partially liable as well. To be precise, medical facilities bear liability if malpractice is from their employees, including nurses, technicians, and support staff. A hospital may be liable for a doctor’s negligence if a doctor is claimed to be its employee. In turn, a facility is traditionally not responsible for the wrongful actions of doctors who are independent contractors. There are only two exceptions in this case – a hospital bears liability for a contractor’s malpractice if it was aware of his incompetency and if it misinformed patients about a doctor’s status, presenting him as an employee. Moreover, independent contractors are legally responsible for the negligence of clinicians who are under their supervision.
Conclusion
If a patient’s injury or death was not caused by medical negligence or this fact cannot be established, neither medical facilities nor independent contractors bear liability. Thus, based on the case’s analysis presented in a form of a particular plan, in the case of Kay Chee, the fact of the nurse’s medical negligence that led to the patient’s death could not be identified, and both the nurse and Queen Mary Hospital cannot be legally prosecuted. To improve patient outcomes in the future, a hospital should consider the recommendations of jurors to improve the quality of its healthcare delivery and minimize the risks of medical negligence and misadventure at the same time as much as possible. Otherwise, the hospital may be legally responsible for patients’ negative outcomes if it does not take action being aware of potential issues.
References
Adejumo, O. A., & Adejumo, O. A. (2020). Legal perspectives on liability for medical negligence and malpractices in Nigeria. The Pan African Medical Journal, 35(44), 1-9. Web.
Cozzolino, M., Mangano, M., Stucchi, A., Ciceri, P., Conte, F., & Galassi, A. (2018). Cardiovascular disease in dialysis patients. Nephrology Dialysis Transplantation, 33(3), 28-34. Web.
Hui, S., & Shum, M. (2021). Dialysis tragedy spurs call for ICU shake-up. The Standard. Web.
Shali, S. (2017). Medical negligence in India: Current issues and ethics. International Journal of Advance Research, Ideas and Innovations in Technology, 3(6), 798-803.