Discussion Thread 4
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Res Ipsa Loquitur
Nilegaonkar & Kulkarni (2019) defines Res Ispa Loquitur as in the absence of negligence,
the act itself is the evidence. Res Ispa Loquitur helps provide fairness to injured patient's
when direct evidence of negligence is absent (Nilegaonkar & Kulkarni, 2019). Burden of
proof must be exhibited when applying Res Ipsa Loquitur by accomplishing three elements;
(1) the event must be one that normally does not occur in the absence of the defendant’s
negligence, (2) the defendant had exclusive control of the event, and (3) the plaintiff must
not have had any voluntary action or contribution in the event (Shenoy et al., 2022). If any
of these elements cannot be proven, then Res Ipsa Loquitur does not apply. Shenoy et al.
(2022) provide an example of a case where Res Ispa Loquitur has been applied are cases in
which a surgical sponge or a medical instrument was left inside of a patient.
Case Recommendation
Regarding this case, the hospital will be held liable for the actions of the OR staff. To prove
Res Ipsa Loquitur or "the thing speaks for itself", three elements of burden of proof must be
shown. These three elements are (1) if the event would have occurred without negligence,
(2) did anyone else take over or have control of any part of the event or was there a
malfunction with equipment and (3) did the patient contribute to the injury? In Mr. Price's
case, burden of proof is shown as the registered nurse on duty prepped the patient for
surgery after the doctor and patient signed the correct limb and was negligent by prepping
the wrong leg. The hospital has a duty to provide the best care to each patient and this was
breached when the incorrect leg was prepped. The OR staff and the doctor were always in
control of all parts of the procedure and equipment. There also were not any malfunctions
with any equipment that was being utilized for the procedure. The patient did not
contribute to his injury as he was pre-sedated at the time of the prep work in the operating
room. The fact the patient was pre-sedated is very important in this case. If the patient was
awake and had an opportunity to speak for himself, there may have been a better outcome.
Also, the policies and procedures of OR prep were not followed per the conversations with
the surgical RN and the operating doctor. In the morning, they only took 10 minutes to
discuss each surgical patient and when referring to this patient, the leg was not referred to
as right or left, but as "the diseased leg". Res Ipsa Loquitur would be applicable in this case
as the three elements of burden of proof have been proven.
Biblical Integration and Conclusion
Proverbs 25:8 states do not hastily bring into court, for what will you do in the end, when
your neighbor puts you to shame? (NIV, 2011). Typically, when Res Ipsa Loquitur is
applicable to a case, the negligence is painfully obvious. As a medical professional,
understanding the consequences of your actions and learning from them are essential.
These events are very unfortunate, especially for the patient's who suffer. The only silver
lining would be to make every effort to grow, implement new policies and procedures, and
enforce the highest quality of care.
References
Nilegaonkar, S., & Kulkarni, P. (2019). Res ipsa loquitur.
Indian Journal of Medical and
Paediatric Oncology,
40
(2), 270-271.
https://doi.org/10.4103/ijmpo.ijmpo_167_19
Shenoy, A., Shenoy, G. N., & Shenoy, G. G. (2022). Res ipsa loquitur: An insight into the novel
seven ‘I's of indicative treatment - a potential defense for the defendant doctor.
Ethics,
Medicine and Public Health
,
21
, 100751.
https://doi.org/10.1016/j.jemep.2021.100751
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