Malpractice And The Nurse Practitioner

Introduction

The importance of nurse practitioners in the healthcare sector can never be underestimated. They are primarily charged with the responsibility of treating both mental and physical ailments via all-inclusive history taking, tests, as well as undertaking physical tests for interpretation. In addition, they can offer a diagnosis and make recommendations pertaining to varied chronic and acute ailments within the range of their practice, as well as offer proper treatments for patients such making medical prescriptions (Noland & Carl, 2006) However, there are instances, in the course of undertaking their duties, when they are charged with medical malpractice. Medical malpractice may be related to routine visits that a patient makes to a practitioner, stays in the long-term care facilities or even surgical procedures and prescriptions that they are given. The term is used to refer to negligence that healthcare providers or medical professionals commit in the course of their duties to the patient (Noland & Carl, 2006). It is worth noting that malpractice would only occur in instances where the result of such negligence harms the patient. In instances where a claim is levied against a healthcare provider or medical professional, the entity or individual against whom the claim has been made would undergo judgment on varied aspects pertaining to the care that they delivered including their professionalism, competence, care provided, as well as the manner in which the elements compare to the competence and training level that they have (Noland & Carl, 2006). On the same note, the medical facility or healthcare professional would be judged against the actions of other medical professionals who have previously acted in good judgment, as well as a high standard of care in the same or similar cases (Noland & Carl, 2006). In cases where the case is incomparable or is not up to the standards of care that is offered by other healthcare professionals, the claim would potentially be actionable.

Case study

In the case provided, the plaintiff was a 27 year old female who was receiving physical therapy after undergoing a surgical procedure on her ankle. The nurse practitioner had tried to relieve the pain of the plaintiff by applying a hot pack to the affected area. In addition, the plaintiff was given some medications to relieve his pain. The documentation done by the nurse practitioner in the plaintiff’s record showed that the hot pack had the right temperature and was applied for the appropriate duration for heat treatment. However, there existed no documentation showing that the skin of the plaintiff had been checked in the course of the treatment. Nevertheless, the plaintiff had not complained of any discomfort in the course of or even after the treatment. After leaving the facility, the client reported that there was a burn at the site where heat treatment had been done on her ankle. Photographs taken on the site showed a dime-sized severe burn at the ankle, with the client alleging that he was experiencing severe pain, inability to stand, restricted movement of the ankle, as well inability to walk and sit for an extended period. In addition, she complained that the palliatives administered to her were triggering allergic reactions in her body including insomnia, extreme fever, constipation and skin rashes. On the same note, the plaintiff alleged that the severe scarring emanating from the burn hindered him from continuing with the customary habit of attending a gym, walking 5 miles a day or even enjoying the beach. This resulted in the inability to undertake regular activities thanks to the pain, as well as the embarrassment emanating from the scaring, the rashes, and the significant weight gain from her inactivity.

As much as there exist no clear departure from what may be considered standard of care, it is evident that the plaintiff had a severe burn that led to some functional alteration, as well as scarring. In addition, it is evident that the burns and scarring emanated from the heat treatment that the nurse practitioner applied on the plaintiff’s ankle after the plaintiff had undergone a surgical procedure. As much as the defendant had undertaken the appropriate treatment within the appropriate period, he was liable considering that there existed no documentation explaining the severe burn suffered by the patient, or indicating that the defendant nurse practitioner had specifically checked the skin of the patient prior to, in the course of, as well as after applying the heat treatment (Budetti, 2005).

Varied defense options are available to the nurse practitioner in this case. While it may be true that the client or plaintiff had suffered some allergies from the medications that were administered as pain killers, it is evident that the client had not indicated such allergies in giving his medical history. This is an often-neglected responsibility of the patient. It is always imperative that the client informs the nurse practitioner about any allergies, present and past medical conditions and their treatments, not to mention any familial ailments or conditions for which he has knowledge (Mello & Kelly, 2005). It is worth noting that the failure to disclose such information would potentially lead to serious jeopardizing of the care offered by the nurse practitioner and would essentially amount to patient negligence, which is also referred to as contributory negligence (Mello & Kelly, 2005).

In addition, the nurse practitioner can take defense in the fact that he followed due procedure and took due diligence in administering the therapy (Mello & Kelly, 2005). This is especially considering that heat treatment was the appropriate therapy for the ankle injury, not to mention the fact that it was administered in the right manner and within the appropriate temperature. This means that the damage or harm that the plaintiff underwent was an unavoidable risk pertaining to the procedure, in which case the nurse practitioner should not be liable (Kessler & McClellan, 1996). This defense hearkens to the issue of informed consent, where the nurse practitioner had properly informed the plaintiff as to the procedure that would be undertaken, to which the plaintiff had agreed. On the same note, the defense against the malpractice would revolve around the fact that the condition or prognosis was nor worsened by the medical malpractice that is alleged by the plaintiff (Kessler & McClellan, 1996). It is worth noting, in addition, that the plaintiff had not complained of any discomfort during the process or after the heat treatment was applied, but did it long afterwards.

However, this does not undermine the fact that the nurse entrepreneur is liable to the extent that he did not undertake examination of the skin prior to, in the course of, or even after the application of the heat therapy. In essence, he would be required to compensate the plaintiff. Needless to say, a large number of practitioners and healthcare facilities usually have medical professional liability insurance or medical malpractice insurance, which covers professional liability arising from failure to undertake due care, as well as standards of care that is expected of them (Mello & Kelly, 2005).

The nurse practitioner in this case would be covered against the claims of negligence. This is essentially what medical malpractice insurance cover. This means that any settlement that the nurse practitioner would be required to do as a result of his negligence would be covered by the insurance to the extent of the insured amount (Hellinger & Encinosa, 2006). In addition, the amount that the nurse practitioner would be required to incur as legal expenses would be catered for by the insurance as part of the medical malpractice insurance cover (Budetti, 2005). It is worth noting that there are instances where insurance companies would fail to compensate or cover liability. Typical exclusions would include illegal conduct, misrepresentation of items during application for insurance, sexual improprieties, as well as alteration of hospital or medical records (Hellinger & Encinosa, 2006). None of these issues are present in the case provided, in which case the insurance company would be covering the nurse practitioner.

In conclusion, nurse practitioners are charged with the responsibility of treating both mental and physical ailments via all-inclusive history taking, tests, as well as undertaking physical tests for interpretation. However, even the best practitioner may be charged with negligence or medical malpractice. This is the case for the provided instance. While the application of the heat treatment may have resulted in burns and the palliatives triggered allergic reactions, the plaintiff had not disclosed all medical history. On the same note, the nurse practitioner had carried out the correct procedure in the correct manner and with the appropriate temperature. However, his failure to check the skin prior to, during and after the skin treatment renders him liable in which case his insurance should compensate the plaintiff for the malpractice and the legal expenses.

References

Budetti, P.P (2005). Tort Reform and the Patient Safety Movement. JAMA. Vol. 1: 293(21):2660-2662

Hellinger, FJ & Encinosa, WE (2006). The Impact of State Laws Limiting Malpractice Damage Awards on Health Care Expenditures. Am J Public Health. Vol. 96(8):1375-81

Kessler, D & McClellan, M (1996). Do Doctors Practice Defensive Medicine? Quarterly Journal of Economics, vol. 111(2): 353-390.

Mello, MM & Kelly, CN (2005). Effects of a Professional Liability Crisis on Residents’ Practice Decisions. Obstet Gynecol. Vol. 105(6):1287-95.

Noland, C & Carl W.J, (2006). “It’s not our ass”: medical resident sense-making regarding lawsuits. Health Commun. Vol. 20:81-89.

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