Unit 4 Discussion - Domko

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Dec 6, 2023

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Memo Date: 11/08/2023 To: Jeff Passmore, General Counsel, Bright Road Health System From: Keri Domko, Hospital Administrator RE: Mr. Davis Problem: Mr. Davis was given several diagnostic options for treatment of an undiagnosed heart condition. He did not agree to all the options and expressed his wishes on what he wanted and what he did not want. One of the procedures that he did not want was performed during his treatment resulting in the need to be on medication to prevent blood clots and follow up treatment. Mr. Davis has filed a negligence lawsuit against both the provider and the hospital (Toolwire, n.d.) Reason for Recommendation: To determine the following: Was informed consent obtained and how What are the implications for the staff and the hospital What could happen at trial Should the hospital settle or go to court Prevention of future incidents Module 4: Informed Consent HA518 A 1
Failure to Obtain Consent Keri M. Domko Park University HA517DL : Legal and Ethical Issues in Healthcare Administration Dr. James Baird November 8, 2023 Module 4: Informed Consent HA518 A 2
Problem Statement Mr. Davis was given several diagnostic options for treatment of an undiagnosed heart condition. He did not agree to all the options and expressed his wishes on what he wanted and what he did not want. One of the procedures that he did not want was performed during his treatment resulting in the need to be on medication to prevent blood clots and follow up treatment. Mr. Davis has filed a negligence lawsuit against both the provider, Dr. Fredricks, and the hospital (Toolwire, n.d.) Informed Consent According to the AMA (n.d.), patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care. In this case, Mr. Davis signed the informed consent, but clearly crossed out the part that involved placing stents. Dr. Roso, radiologist, feels that Mr. Davis was pressured into the procedure to begin with as he verbalized that he did not want the cardiac catheterization. However, given all the information, with no indication that he was not offered alternative options, Mr. Davis ultimately did sign consent for the catheterization but did not want the stints. In fact, he even was present enough to initial and date the spot where he crossed out that portion of the consent. Implications Implications to both the provider and the hospital are beyond the financial repercussions of a lawsuit. Tawose (2008) states in past tort cases, physicians have been found guilty of assault and battery because they did not allow their patients to be the final decision makers about undergoing a medical procedure. This could lead to criminal consequences for the provider in addition to the civil consequences to hospital. Trial Possibilities One of the first legal cases concerning the acknowledgment of the patient’s right to be informed and to self-determination about his/her health dealt with the American case Shloendorff v. New York Hospital in 1914. The landmark judgment about the aforementioned judicial matter stated that “… Every human being of adult years and sound mind has a right to determine what shall be done with his own body; and a surgeon who performs an operation without his patient’s consent, commits an assault, for which he is liable in damages (Pallocci et al., 2023)” This means that if Mr. Davis’ case goes to trial, Dr. Fredericks could face assault charges and a jury could award Mr. Davis an exorbitant monetary award. Module 4: Informed Consent HA518 A 3
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Settlement vs. Court LSU (n.d.) states every human being of adult years and sound mind has a right to determine what shall be done with his own body; and a surgeon who performs an operation without his patient’s consent commits an assault for which he is liable in damages. This is true except in cases of emergency, where the patient is unconscious and where it is necessary to operate before consent can be obtained. With this being the case, and evidence clearly shows that Dr. Fredricks failed to adhere to Mr. Davis’ wishes while being employed by Bright Road, it would behoove the organization to settle with Mr. Davis rather than risk the serious consequences of going to trial. Prevention Recommendation is that full review of consent forms be added to the pre-procedure time- out to ensure that patient wishes are adhered to. This will necessitate a training plan and enforcement of the hospital policies that are already in place. According to Tine Health (2022), t raining solidifies employees’ existing skills and helps them improve in lacking areas. An effective training program spots individual areas of improvement in order to address them properly. This enables every staff member to be independently effective when it comes to performing their roles without relying on fellow employees who are more experienced with specific tasks. Module 4: Informed Consent HA518 A 4
References AMA. (n.d.). Informed consent . AMA. https://code-medical-ethics.ama- assn.org/ethics-opinions/informed-consent Failure to Obtain Consent . Toolwire. (n.d.). https://canvas.park.edu/courses/77636/modules/items/55750 93 LSU. (n.d.). Battery-No Consent. https://biotech.law.lsu.edu/map/BatteryNoConsent.html Pallocci, M., Treglia, M., Passalacqua, P., Tittarelli, R., Zanovello, C., De Luca, L., Caparrelli, V., De Luna, V., Cisterna, A. M., Quintavalle, G., & Marsella, L. T. (2023, January 24). Informed consent: Legal obligation or cornerstone of the care relationship? . International journal of environmental research and public health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9915667/ Tawose, O. M. (2008, August 1). The legal boundaries of informed consent . Journal of Ethics | American Medical Association. https://journalofethics.ama-assn.org/article/legal-boundaries-informed- consent/2008-08 Tine Health. (2022, August 25). How to Develop Effective Hospital Training and Development Programs . Tine Health. https://tinehealth.com/2017/05/02/how-to-develop-effective-hospital-
training-and-development-programs/#:~:text=How%20to%20Develop %20Effective%20Hospital%20Training%20and%20Development,Hospital %20Training%20Objectives%20...%205%20Tine%20Health%20
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