Discussion board replies

Instructions

Reply prompt: Respond to the two discussion questions from 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. Replies must be at least 450 words each discussion reply. Each reply must reference at least 3 scholarly sources and follow current APA format (including both in-text citations and a reference list). You must also support each reply with thoughtful analysis (considering assumptions, analyzing implications, and comparing/contrasting concepts and include thorough biblical worldview integration.

Discussion Question #1

Liability would ultimately fall upon the hospital as they failed to enforce the policies and procedures.  There was not signage posted in the rooms and they failed to equip the staff with the proper tools they need in all rooms.  The staff are employees not independent contractors, meaning that they fall under respondent superior and can be held liable to the employer for his or her actions.  Some facts about this case that are interesting is that the nurses did not notify the Dr. Paltrow in a timely manner of the staph infection that was contracted by Mrs. Smith.  Regardless if he was on vacation, the physician needs to know what is going on with their patient so he can assess and treat.  Mr. Smith did what he could for his wife but ultimately, the nurses on duty should have informed Dr. Paltrow immediately. 

Doctors have a duty to care for their patients when they are in the hospital, or even if they speak on the phone.  The doctor is acknowledging that they will provide care to the patient.  In this case, duty to care was not performed as Dr. Paltrow was “preoccupied” because he was going on vacation and he did not provide the proper care to the patients.  He failed to change gloves after each patient which was a breach of duty because he failed to provide an acceptable standard of care to the patients.  A question that can arise is “Did Dr. Paltrow know that patient #1 had a staph infection at the time of examination?” If he had knowledge that patient #1 had a staph infection, he contaminated the sterile environments of all patients by not changing gloves or washing his hands, hence the other patients contracting a staph infection, breaching the duty to care.  Ms. Brigham acknowledged that a staph infection is contracted through contact and is not an airborne disease that could be contracted through the air, like Dr. Paltrow had said.  The claim from Dr. Paltrow that she contracted the staph infection due to the gloves being in her trash can, would put the doctor at fault as well.  And since he is an employee of the hospital, the hospital is liable along with all parties involved. 

Speaking with Jennifer Brainard, Post-Surgical Nurse on duty at time of incident witnessed Dr. Paltrow not changing gloves before examining each patient and should have spoken with Dr. Paltrow about not changing gloves after he examined the first patient. She failed to follow duty to care as well.  Regardless of position within the floor unit, all persons have a duty to care because they are caring for patients.  When Ms. Brainard got word that Mrs. Smith had contracted staph, she should have immediately contacted Dr. Paltrow to inform him of the condition of Mrs. Smith.  Ms. Brainard also had an understanding that gloves needed to be changed after each patient along with proper hand washing to prevent too spread of disease.  Ms. Brainard should have let Dr. Paltrow know that he should change gloves immediately after examining the first patient to prevent the spread of an infectious disease that patient #1 might have had.  Understandably knowing that after each patient, gloves should be removed and hands washed as proper procedure. Ms. Brainard also noted that Dr. Paltrow seemed to be distracted on that day which causes liability to fall upon Dr. Paltrow.

Speaking with Dr. George Paltrow, he does not want to accept any form of responsibility and keeps saying he doesn't really recall the day or the day is a haze. Is the fact that he was distracted the cause of him not recalling the day of the incident?  Doctors are busy, see a number of patients through-out the day and can’t recall every step they take, but he should remember if he didn’t follow policies and procedures. A patient contracted a staph infection due to failure to provide duty to care and follow policies and procedures. When he was notified of the staph infection, he had an attitude of "watch and wait” (according to the nurse, which would constitute as hearsay) which also prolonged the care of Mrs. Smith.

Doctor Holly Brigham would not be held liable in the case due to the fact that she did not breach the duty to care of the patient.  She was brought in after the fact and accessed the patient and provided the care to the patient that she needed in a timely manner.

Ultimately, negligence liability falls on the hospital because it failed to provide a standard of care of the patients and failed to enforce their policies and procedures they had in place. Being a hospital, they need to ensure that they have a sterile environment to prevent the spread of infection and Mrs. Smith, I believe, has a case against the hospital to include the nurse on duty and Dr. Paltrow. 

References:

Sokol, D. (2012). ETHICS MAN: Law, ethics, and the duty of care: When it comes to duty of care, the law, unlike ethics, does not always yield a clear answer.BMJ: British Medical Journal, 345(7878), 29-29. Retrieved from http://www.jstor.org/stable/23278980

Hopkins, A. (2015, Summer). The need for a general duty of care. Houston Journal of International Law, 37(3), 841+. Retrieved from http://ezproxy.liberty.edu/login?url=http://go.galegroup.com.ezproxy.liberty.edu/ps/i.do?p=LT&sw=w&u=vic_liberty&v=2.1&it=r&id=GALE%7CA427962412&sid=summon&asid=e2aca21d390df4dea061ad7c9a6d1979

Griffith, R. (2008). Abuse and the law: a breach of duty. Nursing & Residential Care, 10(7), 357-361.

Sartorio, C. (2007), Causation and Responsibility. Philosophy Compass, 2: 749–765. doi:10.1111/j.1747-9991.2007.00097.x

Ozonoff, D. (2005). Legal causation and responsibility for causing harm. American Journal of Public Health, 95, S35-8. Retrieved from http://ezproxy.liberty.edu/login?url=https://search-proquest-com.ezproxy.liberty.edu/docview/215090371?accountid=12085

Discussion Question #2

In tort law, a duty of care is a legal obligation which is imposed on an individual requiring adherence to a standard of reasonable care while performing any acts that could foreseeably harm others. It is the first element that must be established to proceed with an action in negligence. The claimant must be able to show a duty of care imposed by law which the defendant has breached. In turn, breaching a duty may subject an individual to liability. The duty of care may be imposed by operation of law between individuals with no current direct relationship (familial or contractual or otherwise), but eventually become related in some manner, as defined by common law.

 Mrs. Smith was admitted to the hospital for surgical and post-surgical care. The hospital and its staff members was required to provide the highest level of care by following the policies, guidelines and procedure of care. Unfortunately in the case of Mrs. Smith duty of care was undermined and breached. Breach of duty usually occurs when one person or company has a duty of care toward another person or company, but fails to live up to that standard. A person may be liable for negligence in a personal injury case if his breach of duty caused another person's injuries and that exactly what happened to Mrs. Smith; the hospitals staffs breached the duty of care. After she contracted the infection the nurse supposed to call the infection control unit in the hospital not the priest.     

Elements of negligence must be proven to establish malpractice: duty, breach of duty, damages and causation. Duty refers to an existence of a professional relationship between the patient and the health care provider and the degree of legal obligation required once the basic relationship is established. Cases involving breach of duty and evidence of causation are discussed (Fiesta, J. 1997). Negligence is known as the failure to give ordinary care in most case.  Ordinary care is what a reasonably prudent person would do in the same or similar circumstances.  Ordinary care is also referred to as reasonable care.  Because the standard of reasonable care is so general, it is usually necessary to examine the facts and circumstances of the particular case to determine whether reasonable care was used or not. Mrs. Smith contracted the staph infection during her stay at the hospital. Dr. Paltrow was the doctor who attended to Mrs. Smith eye witness (Nurse Jennifer) claims; Dr. Paltrow didn’t change gloves between patients after attending to the first patient who was an amputee and has the staph infection he moved on to the next patents without changing gloves. He (Dr. Paltrow) even washes his hands in Mrs. Smith’s sink and this is not an acceptable procedure in care giving.  

Negligence is known as the failure to give ordinary care in most case.  Ordinary care is what a reasonably prudent person would do in the same or similar circumstances.  Ordinary care is also referred to as reasonable care.  Because the standard of reasonable care is so general, it is usually necessary to examine the facts and circumstances of the particular case to determine whether reasonable care was used or not. Mrs. Smith contracted the staph infection during her stay at the hospital. Dr. Paltrow was the doctor who attended to Mrs. Smith eye witness (Nurse Jennifer) claims; Dr. Paltrow didn’t change gloves between patients after attending to the first patient who was an amputee and has the staph infection he moved on to the next patents without changing gloves. He (Dr. Paltrow) even washes his hands in Mrs. Smith’s sink and this is not an acceptable procedure in care giving.  

The first step in establishing liability is to show that there is something about what the defendant did that justifies imposing the cost of the plaintiff’s (Mrs. Smith) injury upon the defendant rather than the plaintiff.  It may be, for example, that the defendant acted negligently; alternatively, the defendant may have acted with reasonable care, but was engaged in an activity that creates such a high risk of danger that accidents caused by that activity should be borne by the defendant rather than the innocent victims.  In most cases the plaintiff can establish a breach of duty either by showing that the defendant (the hospital) was negligent or by establishing that the defendant is subject to strict liability. Though Dr. Paltrow claim Mrs. Smith may have caught the infection through airborne, Dr. Holly disagree with his claims. Dr. Holly (the Pulmonologist) said Mrs. Smith staph infection was cross contaminated one dues to Dr. Paltrow not changing gloves between patients. Positive and negative motives and outcomes were manipulated in a series of short vignettes, along with whether the outcomes of behavior were relatively foreseeable or unforeseeable. Subjects rated the actor's responsibility for the outcome and for the goodness or badness of the actor's intentions (Alicke, M. D., Weigold, M. F., & Rogers, S. L. 1990). Dr. Paltrow conduct during providing care to Mrs. Smith was not proper and that result to cross contaminating Mrs. Smith and other patients with the Staph infection.

In conclusion, the hospital is liable for the staph infection Mrs. Smith contracted because proper policy and procedure was not followed by the staffs.

NIV (Deuteronomy 7:12 ) If you pay attention to these laws and are careful to follow them, then the LORD your God will keep his covenant of love with you, as he swore to your ancestors.

References

Fiesta, J. (1997). Legal update--1996, part 3. Nursing Management, 28(7), 24-6. Retrieved from http://ezproxy.liberty.edu/login?url=https://search-proquest-com.ezproxy.liberty.edu/docview/231427512?accountid=12085

Alicke, M. D., Weigold, M. F., & Rogers, S. L. (1990). Inferring intentions and responsibility from motives and outcomes: Evidential and extra-evidential judgments. Social Cognition, 8(3), 286-304. doi:http://dx.doi.org.ezproxy.liberty.edu/10.1521/soco.1990.8.3.286