IHP420 Milestone One
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Southern New Hampshire University *
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IHP-420-X5
Subject
Health Science
Date
Jun 10, 2024
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docx
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5
Uploaded by MasterCrownRook6
Oshea Penn
IHP-420
Milestone One
May 22, 2022
Case Study
Rosalinda Iturralde, personal representative of the estate of Arturo Iturralde is the plaintiff in this medical malpractice case. Hilo Medical Center, Hawai’i health systems corporation, State of Hawai’i, Medtronic Sofamor Danek, USA, and Robert Rickertson M.D. are the defendants in this case. In January of 2001 Arturo went into the hospital to be assessed for increasing weakness in his legs which led to several falls. He was then examined by Dr. Ricketson an orthopedic surgeon on January 24, 2001. He was diagnosed with degenerative spondylolisthesis L4-5 with stenosis, this was a condition that could be relieved by a spinal fusion surgery which simply involved implanting two rods into Arturo’s spine. After speaking with Dr. Ricketson Arturo agreed to the surgery and it was scheduled for January 29, 2001. Following the procedure, it had come to the attention of the staff that an inventory check was never performed before the surgery for the rods which led to the staff not being able to find the rods. Instead of closing or seeking an opinion from another college Dr. Ricketson took a stainless-steel screwdriver that was included in the kit and made it so that it would fit as placement for the titanium rods, knowing that this was not certified for human implantation. Dr. Ricketson never informed Arturo of what happened and proceeded with letting him know that he
would need to begin physical therapy which also led to another major fall. Legal Components
According to the textbook malpractice is negligence or other wrongdoing committed by a
professional person, such as a medical professional (2020). In this case it could be seen that Dr. Ricketson was negligent. He did not consult with another physician to try and come up with another plan or see what they thought. He also did not try to wait for the rods even though it would have taken 90 mins for the rods to get there. Since Dr. Ricketson discussed the case in full
with Arturo and told him what would happen and what was going to be implanted into him it was
negligent of him to defer from the plan and put a make shift rod in him that was not certified for human implementation anyway. This is not what Arturo agreed to. Once starting physical therapy post-surgery, the patient fell which led to the makeshift rods to shatter. It can also be determined that Mr. Arturo’s death was caused by the damages in this case. Malpractice Policies
There are many policies that help in the aid to stop malpractice and help patients. According to WHO urgent action by countries and partners around the world is needed to help reduce patient harm in health care. Patient safety and quality of care are essential for delivering effective health services and achieving universal health coverage (2019). In this case HCM implemented policies such as verifying all equipment and instruments be present before a procedure is to begin. As you can see in this case, that was not done it was not until 2 hrs. into the procedure that the staff noticed that the rods were missing. The hospital put this policy into place to help limit the risk of unnecessary things happening during the procedure. Standard of Care
“Treatment that is accepted by medical experts as a proper treatment for a certain type of disease and that is widely used by healthcare professionals. Also called best practice, standard
medical care, and standard therapy” (NCI, 2022). When Arturo consented to the operation, he put his trust in Dr. Ricketson. This trust was then violated when Dr. Ricketson implanted Arturo with the makeshift rods and then did not tell him what he did. Dr. Ricketson didn’t even try to get him to come back so he could then put in the actual rods that should have been put in and correct his mistake. Since Mr. Arturo was also injured after the surgery this led to unintentional tort by Dr. Ricketson. Physicians must adhere to a higher standard of care and since the surgery did not go as planned immediately after surgery Dr. Ricketson should have notified Arturo of the
outcome and what led to his decision. He violated Mr. Arturo’s trust and rights by keeping this crucial information from him. Cultural Backgrounds
According to Fremgen “In U.S. hospitals, there has been, in the past, a “dumping crisis” of indigent patients who lack medical insurance” (2020). In this case this does not pertain to Mr. Arturo because he is not an indigent patient. However other physicians might see this as a way to
use this makeshift screwdriver as cheaper temporary fix for patients who don’t have healthcare or for those who they feel don’t deserve the titanium rods. This could make patients very scared to trust doctors because they feel like they say one thing and do another. How can they really know that got what they needed done and the physician didn’t just throw some random object in their body that would later make their symptoms a lot worst. Accountability
After reading this case I believe that Dr. Ricketson was held accountable for his actions. The court and jury also deemed him responsible for his actions and part in Mr. Arturo’s procedure. The jury apportioned 65% of the fault to Dr. Ricketson and 35% to HMC. I do
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believe that Dr. Ricketson should not have been allowed to practice medicine anymore due to his
actions and lack of care for his patient. He made a bad situation worst and didn’t give two thoughts about it.
References:
Fremgen, B. F. (2020). Medical law and ethics
. Pearson. Institute, N. C. (2022). NCI Dictionary of Cancer terms
. National Cancer Institute. Retrieved May 22, 2022, from https://www.cancer.gov/publications/dictionaries/cancer-terms/def/
standard-of-care Organization, W. H. (2019, September 13). Who calls for urgent action to reduce patient harm in
healthcare
. World Health Organization. Retrieved May 22, 2022, from https://www.who.int/news/item/13-09-2019-who-calls-for-urgent-action-to-reduce-patient-
harm-in-healthcare Surgery: Iturralde v. Hilo Medical Center USA