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Mr. Willie Abraham was a frequent patient in the Emergency Room. He had been seen many times for fractures, contusions, and lacerations that were all related to his abuse of alcohol.
One Saturday night about 10 pm Mr. Abraham was brought to the ER by Fire Rescue. He had been involved in an altercation with another man in a bar.Mr.Abraham’s face was badly contused, with swelling noted over his nose and right eye. A 2 inch laceration was noted on his right cheek. He denied any loss of consciousness. His blood alcohol was 2 times the legal limit according to the police officers at the scene.
Upon admission Mr. Abraham was non-cooperative. He insisted that he needed to leave and go back to the bar to “give the other guy a taste of his own medicine”.
While waiting testing and treatment, soft wrist restraints and a Posey vest were placed on the patient. The nurses caring for this patient knew that he could untie his restraints so they moved him to a room nearest to the nurses’ station. They also initiated a system whereby the patient was checked at least every hour while in restraints. The bed and vest restraints were tied securely. Regardless of these safety measures, Mr. Abraham managed to get out of his restraints. He was found at the foot of his bed where he had tried to get out of bed but instead fell on his head. He suffered a depressed skull fracture, had an intracranial bleed, and died about 48 hours later.
The nurses’ notes that was written 10 minutes before the fall indicated that the restraints were tied securely and the patient denied any discomfort. His CNS checks were normal.
The Abraham family brought suit against the hospital, the doctors and the nurses for wrongful death and negligent patient care.
Questions
1-what principle of protecting patient safety are involved in this case?
2-what more could the nurses have done, from a legal perspective, to prevent this injury?
Is there a greater duty to this patient from an ethical perspective? Why or why not?
3-is there a greater duty to this patient from an ethical perspective? Why or why not?
4-what ethical principles must be considered when caring for such a patient?
5-who are the defendants in this case? Which defendants could potentially be held liable? Why?
6-how do you think the court would rule in such a case? Why?
7-give examples of court rulings that support your opinions.
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