Case Analysis
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Case Analysis 2
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Case Analysis 2: Yabarra v. Spangard Kazi Moonmoon HCMG 730 November 18, 2012
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1. Which form of negligence best fits this case? This case is a very good example of how during a surgical procedure a patient can undergo some injuries caused by negligence among either surgeons or the group of doctors/nurses that are involved in it. The application of res ipsa loquitur was successfully established in the case as it clearly met all the underlying requirements for it to be proven. According to the textbook there are three underlying elements that are required for res ipsa loquitur to be established: 1. the injury is of such character that it would not ordinarily occur without someone’s negligence, 2. The medical professional had exclusive control and management over the instrument or cause of the accident, and 3. The injury could not have occurred as a result of any action by the patient. (McWay, Edge, & Krieger, 2010) It is clear that in the case of absence of direct proof, res ipsa loquitur allows jury to infer negligence under certain circumstances. It is also clear that during a surgical procedure the patient is in no condition to identify who is responsible or what caused the damages. (Abramson & Dugan, 2012) The patient’s arm being paralyzed and atrophy of the muscles were the specific damages under consideration. First of all, this type of injury is not supposed to occur after a surgery of the appendix. The anesthetist clearly is the person who must not have used proper caution in terms of placing the patient in the surgical table. Under this point we can also argue that the concept of vicarious liability puts the actual surgeon’s at fault as they take the responsibility of the surgery. Second, the medical professionals were the only person in charge to take any action to complete the surgery. They have the exclusive control of all things that are done during the procedure. Finally, the patient did not cause the injury as s/he did not have any problem in their arm or neck prior to the surgery. The patient had undergone treatment to two other physicians who proposed the cause of the injury to be pressure or strain.
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So, we can restate that the form of negligence in this case was res ipsa loquitur where the action clearly speaks for itself. To an extent, we can also argue that the concept of vicarious liability also applies to the surgeons actually performing the procedure as they take the responsibility of the anesthetist involved in the surgery. 2. Are all the elements for a claim of negligence found in the case? Identify each of the four D’s. The four D’s of negligence include: duty, dereliction of duty, direct causation, and damages. (Standards of Care & Malpractice in Psychiatry - Negligence) Below all these four elements are discussed in consideration to this case and hence all the elements for a claim of negligence can be found. Duty: During a surgical procedure a surgeon has duty of care towards the patient. The physicians involved in the surgery are responsible and has the duty of care. The patient remembers that the anesthetist laid him back against two hard objects. The anesthetist had the duty to ask patient if he felt any sort of discomfort while laying him in the surgery table. The other surgeons also has the duty to ensure that while the procedure the patient is not in any physical orientation that can cause the patient strain or damage in the future. Dereliction of Duty: Clearly the anesthetist breached the duty as s/he did not ensure the patients physical comfort. The other two surgeons did not communicate with the anesthetist about possible injuries in the future. The physicians clearly failed to fulfill their duty to the patient as their actions caused the patient to have severe pain initially, which later deteriorated to form paralysis. Direct Causation: The patient under consideration did not have any prior condition that could lead to paralysis of his arm. The physicians he visited after the surgery confirmed that it occurred
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due to trauma or injury by pressure or strain applied between his right shoulder and neck, which he suffered during the surgery while he was unconscious. The patient remembered lying on two hard objects at the top of his shoulders, which could be a significant contributing factor for strain and pressure. Damages: The patient suffered paralysis and atrophy of the muscles under the shoulder. This damage is evident and was confirmed by two other physicians. The damage was directly caused by the physicians involved who had a duty of care towards the patient while undergoing a surgery. Analysis of Verdict: The court’s decision that the physicians involved in a surgery has total control over a patient’s body and the instrumentalities is justified. Res ipsa loquitor in this case was clear as the damage faced by the patient was not something that could be expected after the surgery of appendix. This clearly proves that negligence was present in course of the surgery. The patient remembered lying on two hard objects, as the anesthetist was the person in charge to lay down the patient on the surgical table. The anesthetist failed to communicate with the patient to ensure his physical comfort. The two other surgeons also failed to ensure that the patient undergoing the surgery was laid back in a way that would ensure his safety. This clearly shows that the physicians had a duty towards the patient and they clearly failed to prove that they fulfilled their duty. This also brings into light that the concept of vicarious liability puts the other two surgeons at fault, aside from the anesthetist as they showed negligence that caused the patient paralysis of his arm. The direct negligence of the anesthetist is quite clear in this case as s/he did not care place the patient on the operating table comfortably. The other two physicians had the duty also in course of the surgery
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to look for anything that could cause the patient injuries after the procedure is complete. Res ipsa loquitur does not apply to all tort cases; however it appears only with type of injuries that do not occur unless someone is negligent. (Rottenstein Law Group, 2010) This ties in with the case completely. The patient would have never suffered paralysis if the negligence of the physicians performing an appendectomy took place. A procedure such as appendectomy could not be a contributory factor for someone’s paralysis, unless there was some sort of negligence. In light of our discussion we can conclude that res ipsa loquitur was established in this case and the court’s decision was justified to hold the physicians accountable for the physical damages suffered by the patient.
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Reference:
Abramson, M., & Dugan, K. (2012). Res Ipsa Loquitur and Medical Malpractice . Retrieved November 18, 2012, from Abramson, Brown & Dugan Attorneys Web site: http://www.arbd.com/res-ipsa-loquitur-and-medical-malpractice McWay, D. C., Edge, R. S., & Krieger, J. (2010). Res Ipsa Loquitur. In D. C. McWay, R. S. Edge, & J. Krieger, Healthcare Ethical and Legal Issues with Case Studies (pp. 75-76). Mason: Cengage Learning. Rottenstein Law Group. (2010). What is “res ipsa loquitur”? Retrieved November 18, 2012, from Rottenstein Law Group Web site: http://www.rotlaw.com/legal-library/what-is-res-ipsa-loquitur/ Standards of Care & Malpractice in Psychiatry - Negligence . (n.d.). Retrieved from Arizona Psychiatric Associates, PLLC: http://www.azpsych.com/full_article.php?id=2
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Case Analysis 2: Yabarra v. Spangard Kazi Moonmoon HCMG 730 November 18, 2012
Case Analysis 2
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1. Which form of negligence best fits this case? This case is a very good example of how during a surgical procedure a patient can undergo some injuries caused by negligence among either surgeons or the group of doctors/nurses that are involved in it. The application of res ipsa loquitur was successfully established in the case as it clearly met all the underlying requirements for it to be proven. According to the textbook there are three underlying elements that are required for res ipsa loquitur to be established: 1. the injury is of such character that it would not ordinarily occur without someone’s negligence, 2. The medical professional had exclusive control and management over the instrument or cause of the accident, and 3. The injury could not have occurred as a result of any action by the patient. (McWay, Edge, & Krieger, 2010) It is clear that in the case of absence of direct proof, res ipsa loquitur allows jury to infer negligence under certain circumstances. It is also clear that during a surgical procedure the patient is in no condition to identify who is responsible or what caused the damages. (Abramson & Dugan, 2012) The patient’s arm being paralyzed and atrophy of the muscles were the specific damages under consideration. First of all, this type of injury is not supposed to occur after a surgery of the appendix. The anesthetist clearly is the person who must not have used proper caution in terms of placing the patient in the surgical table. Under this point we can also argue that the concept of vicarious liability puts the actual surgeon’s at fault as they take the responsibility of the surgery. Second, the medical professionals were the only person in charge to take any action to complete the surgery. They have the exclusive control of all things that are done during the procedure. Finally, the patient did not cause the injury as s/he did not have any problem in their arm or neck prior to the surgery. The patient had undergone treatment to two other physicians who proposed the cause of the injury to be pressure or strain.
Case Analysis 2
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So, we can restate that the form of negligence in this case was res ipsa loquitur where the action clearly speaks for itself. To an extent, we can also argue that the concept of vicarious liability also applies to the surgeons actually performing the procedure as they take the responsibility of the anesthetist involved in the surgery. 2. Are all the elements for a claim of negligence found in the case? Identify each of the four D’s. The four D’s of negligence include: duty, dereliction of duty, direct causation, and damages. (Standards of Care & Malpractice in Psychiatry - Negligence) Below all these four elements are discussed in consideration to this case and hence all the elements for a claim of negligence can be found. Duty: During a surgical procedure a surgeon has duty of care towards the patient. The physicians involved in the surgery are responsible and has the duty of care. The patient remembers that the anesthetist laid him back against two hard objects. The anesthetist had the duty to ask patient if he felt any sort of discomfort while laying him in the surgery table. The other surgeons also has the duty to ensure that while the procedure the patient is not in any physical orientation that can cause the patient strain or damage in the future. Dereliction of Duty: Clearly the anesthetist breached the duty as s/he did not ensure the patients physical comfort. The other two surgeons did not communicate with the anesthetist about possible injuries in the future. The physicians clearly failed to fulfill their duty to the patient as their actions caused the patient to have severe pain initially, which later deteriorated to form paralysis. Direct Causation: The patient under consideration did not have any prior condition that could lead to paralysis of his arm. The physicians he visited after the surgery confirmed that it occurred
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due to trauma or injury by pressure or strain applied between his right shoulder and neck, which he suffered during the surgery while he was unconscious. The patient remembered lying on two hard objects at the top of his shoulders, which could be a significant contributing factor for strain and pressure. Damages: The patient suffered paralysis and atrophy of the muscles under the shoulder. This damage is evident and was confirmed by two other physicians. The damage was directly caused by the physicians involved who had a duty of care towards the patient while undergoing a surgery. Analysis of Verdict: The court’s decision that the physicians involved in a surgery has total control over a patient’s body and the instrumentalities is justified. Res ipsa loquitor in this case was clear as the damage faced by the patient was not something that could be expected after the surgery of appendix. This clearly proves that negligence was present in course of the surgery. The patient remembered lying on two hard objects, as the anesthetist was the person in charge to lay down the patient on the surgical table. The anesthetist failed to communicate with the patient to ensure his physical comfort. The two other surgeons also failed to ensure that the patient undergoing the surgery was laid back in a way that would ensure his safety. This clearly shows that the physicians had a duty towards the patient and they clearly failed to prove that they fulfilled their duty. This also brings into light that the concept of vicarious liability puts the other two surgeons at fault, aside from the anesthetist as they showed negligence that caused the patient paralysis of his arm. The direct negligence of the anesthetist is quite clear in this case as s/he did not care place the patient on the operating table comfortably. The other two physicians had the duty also in course of the surgery
Case Analysis 2
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to look for anything that could cause the patient injuries after the procedure is complete. Res ipsa loquitur does not apply to all tort cases; however it appears only with type of injuries that do not occur unless someone is negligent. (Rottenstein Law Group, 2010) This ties in with the case completely. The patient would have never suffered paralysis if the negligence of the physicians performing an appendectomy took place. A procedure such as appendectomy could not be a contributory factor for someone’s paralysis, unless there was some sort of negligence. In light of our discussion we can conclude that res ipsa loquitur was established in this case and the court’s decision was justified to hold the physicians accountable for the physical damages suffered by the patient.
Case Analysis 2
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Reference:
Abramson, M., & Dugan, K. (2012). Res Ipsa Loquitur and Medical Malpractice . Retrieved November 18, 2012, from Abramson, Brown & Dugan Attorneys Web site: http://www.arbd.com/res-ipsa-loquitur-and-medical-malpractice McWay, D. C., Edge, R. S., & Krieger, J. (2010). Res Ipsa Loquitur. In D. C. McWay, R. S. Edge, & J. Krieger, Healthcare Ethical and Legal Issues with Case Studies (pp. 75-76). Mason: Cengage Learning. Rottenstein Law Group. (2010). What is “res ipsa loquitur”? Retrieved November 18, 2012, from Rottenstein Law Group Web site: http://www.rotlaw.com/legal-library/what-is-res-ipsa-loquitur/ Standards of Care & Malpractice in Psychiatry - Negligence . (n.d.). Retrieved from Arizona Psychiatric Associates, PLLC: http://www.azpsych.com/full_article.php?id=2
