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case scenario: Smith, an orthopedic surgeon, has come to you as CEO of the hospital in which he performs many of his total knee replacement...

 case scenario:

Dr. Smith, an orthopedic surgeon, has come to you as CEO of the hospital in which he performs many of his total knee replacement procedures. Dr. Smith is concerned about a series of events that occurred during and after one of the cases he performed approximately one week ago. Dr. Smith shares with you that while in the OR suite, one of the scrub techs who is an employee of the hospital, dropped a retractor on the floor and proceeded to use it before the surgeon could stop him. Dr. Smith shares that other than that event, all other aspects of surgery were normal and there were no issues noted in the post-anesthesia care unit. Subsequently, when the patient arrived on the surgical floor, the nurse administered a blood thinner medication that was prescribed for a different patient. This blood thinner was not on Dr. Smith's patient's medication administration record and had not been ordered for this patient.Dr. Smith tells you that he is concerned about the retractor incident because the patient presented to his office earlier today for follow-up with symptoms that appear to be an infection at the surgical site. He is concerned about the need for up to six weeks of intravenous antibiotic treatment and possibly having to redo the total knee with a new joint. Dr. Smith also informs you that he did not know of the blood thinner issue until the patient told him today about how the "body builder" nurse had informed her not to say anything about the error if she "didn't want to stay longer than necessary." The patient went on to tell Dr. Smith that she felt this was a threat against her and she was extremely afraid the rest of her hospitalization and does not want any further treatment at your facility.

Your job as CEO is to analyze the information you have just been given and to share that information with the hospital's board. You are also to determine if the hospital's policy for insurance will provide coverage for the potential claims that may come from the patient. You should analyze each of the three issues independently (dropped retractor, blood thinner administration, and nurse interaction), explaining briefly what the issue is, what area of tort law it would fall within, and primarily focus your analysis on the ability of the insurance policy to provide coverage. Remember that to have an intentional tort, the actor must intend to cause harm to the person injured. Even if you determine that there are no damages, since you never know what a jury would do, you should include in your analysis your reasoning for why or why not insurance coverage may be available. Also include in your answer how any portion of your analysis regarding insurance coverage might be changed if your facility was self-insured to a limit of $2 million and had a commercial excess coverage policy. To support your analysis, and to further gain the support of the board, you should include at least one outside reference in your report.

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