Guest guest Posted May 30, 2008 Report Share Posted May 30, 2008 Martha was to undergo an MRI to investigate a complaint of back injury. She advised the MRI center's employees by phone the day before the procedure that she would consent to administration only of either morphine or meperidine. The center advised her that their practice was to administer fentanyl. Martha said she would not accept an injection of fentanyl but would accept MS or meperidine. The next day, upon arrival at the MRI center and while being prepped, she asked Nurse Bob what drug he was going to use, and he advised fentanyl. Martha once again advised Nurse Bob that she would not accept fentanyl. Later, after (supposedly) discussing the matter with Martha's physician, Nurse Bob advised Martha that he would administer morphine. However, instead he administered fentanyl. Martha claims that as a result of administration of fentanyl she suffered serious complications, including severe headache, projectile vomiting, breathing difficulties, post-traumatic stress disorder, and vocal cord dysfunction. She sued the MRI facility. What legal issues does this case present? If this involved prehospital care, would the issues be the same? Gene Gandy, JD, LP ************** Get trade secrets for amazing burgers. Watch " Cooking with Tyler Florence " on AOL Food. (http://food.aol.com/tyler-florence?video=4 & amp;?NCID=aolfod00030000000002) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2008 Report Share Posted May 30, 2008 Renny, I would have said the same thing, and I would have been wrong IN THIS SPECIFIC CASE. This is an Arizona case, so let's all remember that law changes from jurisdiction to jurisdiction, but in this case, Duncan v. sdale Medical Imaging, Ltd., et al, No. CV-02-0191-PR, Arizona Supreme Court, 2002, the Court distinguished between " lack of consent " and " lack of informed consent. " In this case, the patient was found to have consented to administration of either morphine or Demerol, but not to fentanyl. Therefore, there was NO consent, and therefore the nurse's actions were battery, not malpractice. On the other hand, if Martha's consent were to the administration of an analgesic, but the risks were not explained to her, giving her the opportunity to speak up about her problems with synthetic opioids, the failure to warn would amount to negligence, thereby allowing an action in malpractice. But since Martha did not consent to administration of fentanyl, and was misled into believing that the injection she was consenting to was not fentanyl, a material misrepresentation of fact, then her cause of action is in battery. The big difference in the two is that in a battery case, Martha is not required to present expert evidence to support her claim. Caution: This is an Arizona case, and it may not apply in all jurisdictions. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2008 Report Share Posted May 30, 2008 Yes, I got an A in Disclaimers and Avoidance. GG > > Gene Gandy wrote " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2008 Report Share Posted May 30, 2008 This is malpractice, regardless if the harm claimed is real or not. It is a violation of patients rights to do any procedure/treatment/medicine without patients consent. This assumes they are legally competent. This would also apply if patient were not legally competent but had prior to event that makes them unable to decide filled out a durable power of attorney or living will with specific medical direction. Any patient has the right to pick and choose what treatment they will accept and your disregarding it would be against all moral and ethical aspects. In hospital or prehospital we still must respect patients rights to determine what we do to them. Prehospital lets say protocol says all fall patients must be backboarded and c-collared. Patient says no. Would you say after first trying to reason with them, I can not take you to the hospital if you refuse these spinal precautions? Hopefully not. Hopefully you would have them sign a refusal of specific treatment or refusal of all treatment but accepting transport. Had you denied all other care and transport to patient for them refusing a treatment would be equal to malpractice, patient abandoment if you left them there. Prehospital it is easy to get locked into protocol says I must do this or that and we forget patients have the right to choose what they will allow regardless of our protocols or opinions. Just my worthless rambling thoughts on the subject. Renny Spencer EMT-I Paramedic Student > > Martha was to undergo an MRI to investigate a complaint of back injury. She > advised the MRI center's employees by phone the day before the procedure that > she would consent to administration only of either morphine or meperidine. > The center advised her that their practice was to administer fentanyl. > Martha said she would not accept an injection of fentanyl but would accept MS or > meperidine. > > The next day, upon arrival at the MRI center and while being prepped, she > asked Nurse Bob what drug he was going to use, and he advised fentanyl. Martha > once again advised Nurse Bob that she would not accept fentanyl. Later, > after (supposedly) discussing the matter with Martha's physician, Nurse Bob > advised Martha that he would administer morphine. However, instead he administered > fentanyl. > > Martha claims that as a result of administration of fentanyl she suffered > serious complications, including severe headache, projectile vomiting, breathing > difficulties, post-traumatic stress disorder, and vocal cord dysfunction. > > She sued the MRI facility. > > What legal issues does this case present? If this involved prehospital > care, would the issues be the same? > > Gene Gandy, JD, LP > > > ************** > Get trade secrets for amazing burgers. Watch > " Cooking with Tyler Florence " on AOL Food. > > (http://food.aol.com/tyler-florence?video=4 & amp;? NCID=aolfod00030000000002) > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 30, 2008 Report Share Posted May 30, 2008 Gene Gandy wrote " Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 Gene, Battery makes sense. It was treatment done against her will. So would the guilty party also be facing jail time besides lawsuit? Renny PS Darn I was going to claim you were my attorney till I saw your disclaimer. > > Renny, > > I would have said the same thing, and I would have been wrong IN THIS > SPECIFIC CASE. This is an Arizona case, so let's all remember that law changes from > jurisdiction to jurisdiction, but in this case, Duncan v. sdale Medical > Imaging, Ltd., et al, No. CV-02-0191-PR, Arizona Supreme Court, 2002, the > Court distinguished between " lack of consent " and " lack of informed consent. " > > In this case, the patient was found to have consented to administration of > either morphine or Demerol, but not to fentanyl. Therefore, there was NO > consent, and therefore the nurse's actions were battery, not malpractice. > > On the other hand, if Martha's consent were to the administration of an > analgesic, but the risks were not explained to her, giving her the opportunity to > speak up about her problems with synthetic opioids, the failure to warn would > amount to negligence, thereby allowing an action in malpractice. > > But since Martha did not consent to administration of fentanyl, and was > misled into believing that the injection she was consenting to was not fentanyl, a > material misrepresentation of fact, then her cause of action is in battery. > > The big difference in the two is that in a battery case, Martha is not > required to present expert evidence to support her claim. > > Caution: This is an Arizona case, and it may not apply in all > jurisdictions. > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2008 Report Share Posted May 31, 2008 I could see a possible criminal assault case, yes. However, apparently it did not happen in this incident. G > > Gene, > Battery makes sense. It was treatment done against her will. So > would the guilty party also be facing jail time besides lawsuit? > Renny > > PS Darn I was going to claim you were my attorney till I saw your > disclaimer. > > --- In texasems-l@yahoogrotexasem, wegandy1938@, wegandy1 > > > > Renny, > > > > I would have said the same thing, and I would have been wrong IN > THIS > > SPECIFIC CASE. This is an Arizona case, so let's all remember > that law changes from > > jurisdiction to jurisdiction, but in this case, Duncan v. > sdale Medical > > Imaging, Ltd., et al, No. CV-02-0191-PR, Arizona Supreme Court, > 2002, the > > Court distinguished between " lack of consent " and " lack of informed > consent. " > > > > In this case, the patient was found to have consented to > administration of > > either morphine or Demerol, but not to fentanyl. Therefore, there > was NO > > consent, and therefore the nurse's actions were battery, not > malpractice. > > > > On the other hand, if Martha's consent were to the administration > of an > > analgesic, but the risks were not explained to her, giving her the > opportunity to > > speak up about her problems with synthetic opioids, the failure to > warn would > > amount to negligence, thereby allowing an action in malpractice. > > > > But since Martha did not consent to administration of fentanyl, and > was > > misled into believing that the injection she was consenting to was > not fentanyl, a > > material misrepresentation of fact, then her cause of action is in > battery. > > > > The big difference in the two is that in a battery case, Martha is > not > > required to present expert evidence to support her claim. > > > > Caution: This is an Arizona case, and it may not apply in all > > jurisdictions. > > > > Quote Link to comment Share on other sites More sharing options...
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