Negligence Paper
Maria Caceres
HCS / 478
March 23, 2015
Meg Larramendy
Negligence Paper
Patient safety is an essential and vital component of quality healthcare. However, the nation’s current health care system is prone to errors, and can be detrimental to safe patient care. A variety of stakeholders including patients, nurses, educators, administrators, physicians, government, legislation, professional associations and accrediting agencies are responsible for ensuring that patient care is safely delivered and that no harm occurs to patients. This paper will discuss the article “Amputation Mishap; Negligence” from the Neighborhood newspaper whereby such a medical error occurred; a wrong site surgery. It will differentiate between negligence, gross negligence, and malpractice. It will also discuss the importance of documentation and the ethical principles that would guide one’s practice as a nurse.
The article in The Neighborhood newspaper focuses on Mr. Benson, a 62-year-old male patient who underwent a below the knee amputation of his lower extremity related to poor circulation and a history of diabetes mellitus. Amputations related to diabetes complications occur every day, however on one particular day the wrong extremity was amputated. Wrong site surgery is defined as a sentinel event, an unexpected occurrence involving death or serious physical or psychological injures by the Joint Commission, which found WSSs to be the third-highest-ranking event (Joint Commission, 2015). As healthcare workers we ask ourselves how such a terrible mistake could happen. Doctors and operating room staff verify paperwork, confirm which side is to be operated on, mark the site and take a “time out” before the operation begins to check that everything is in order. These safeguards are almost always effective, but no system is fail proof. Anytime we have humans involved you can have human error as demonstrated in Mr. Benson’s case. The process failed Mr. Benson gravely. This situation presents itself to differentiate between the three types of medical errors and decide whether the mistake is categorized as negligence, gross-negligence or malpractice in this particular case.
Differentiate between negligence, gross negligence and malpractice
The National Practitioner Data Bank (2008) reports that approximately 4,418 malpractice reports were filed against registered nurses—1,276 against nurse anesthetists, 701 against nurse midwives, 802 against nurse practitioners, and 12 against clinical nurse specialists—for the period September 1, 1990 through September 4, 2008. Of primary importance to health care providers is the area of negligence and malpractice. Though most often used interchangeably, there is a fine distinction between the two terms. Negligence according to Guido, 2010 is a general term that denotes conduct lacking in due care. Negligence equates with carelessness, a deviation from the standard of care that a reasonable person would use in a particular set of circumstances (Guido, 2010). Negligence may also include doing something that the reasonable and prudent person would not do. Common examples of negligence are malnutrition, inadequate hydration, physical injury was done, and it was the result of the nurse’s care or lack thereof. There are five main elements in a nursing negligence case and all five elements have to be proven for a case to be valid 1. The nurse had a duty to perform. 2. The appropriate care was not apparent in the situation. 3. There was a breach of violation of care 3. There was injury proven to result from the nurse’s negligence and 5. There is proof that damages occurred as a direct result of the situation. (Guido, 2010).
Gross negligence is a conscious and voluntary disregard of the need to use reasonable care, which is likely to cause foreseeable grave injury or harm to persons, property, or both. It is conduct that is extreme when compared with ordinary Negligence, which is a mere failure to exercise reasonable care. In terms of medical malpractice, the phrase "gross negligence" is defined as an indifference to and a blatant violation of a legal duty with respect to the rights of others. Some examples of gross negligence are when an operating surgeon amputates the wrong leg, or leaves a surgical instrument in the body of a patient (Guido, 2010).
Malpractice, sometimes referred to as professional negligence, is a more specific term that addresses a professional standard of care as well as the professional status of the caregiver (Guido, 2010). To be liable for malpractice, the tortfeasor (person committing the civil wrong) must be a professional, such as a physician, nurse, accountant, or lawyer (Guido, 2010). Courts have continually defined malpractice as any professional misconduct, unreasonable lack of skill, or fidelity in professional or judiciary duties. Moreover, this wrong or injudicious treatment results in injury, unnecessary suffering, or death to the injured party, and proceeds from ignorance, carelessness, want of proper professional skill, disregard of established rules and principles, neglect, or a malicious or criminal intent (Judson & Harrison, 2010). In a more modern definition, malpractice is the failure of a professional person to act in accordance with the prevailing professional standards or failure to foresee consequences that a professional person, having the necessary skills and education, should foresee (Guido, 2010).