Question

SITUATION # 1
The CRL patient located in cubicle 15 of the Emergency Room constantly complains of abdominal pain in the lower right quadrant. Mrs. Ramos is the nurse in charge of the patient. This goes to the doctor and notifies her that the patient is in a lot of pain. The doctor evaluates the patient and generates a medical order for Demerol 50 mg IM STAT. The nurse, who was very overburdened with tasks, proceeds to execute the order, but in haste she mistakenly takes the order from another patient and prepares Toradol 30 mg IV. Due to her busy shift, she goes to the patient, administers the medication without asking for the name or allergies, and leaves quickly. It should be noted that the nurse did not clean with alcohol before placing the serum on the patient. After 10 min, the patient complains that he cannot breathe and upon inquiring about his history, they realize that he is allergic to Aspirin (Toradol contains aspirin), so he is immediately managed to counteract the manifested allergic reaction. When verifying the file, they realize the negligence committed with the patient.

1. How would you have acted in this situation?
2. What ethical-legal repercussions could arise in this case?

Answer 1

ANSWER :

1.My action in this situation :

• I will notify the patient and their family regarding the medication error occured irrespective of the consequences.
• Inform the rest of the hospital care team so that we can handle the case together for better care plan and management of the patient.
• I will document the medication error and inform it to the hospital safety community.

2.Ethical - legal repercussions :

Ethical issues :

• Regarding disclosure of the medication error occured to the patient.
• There will be breach in the trust between patient and nurse , physician or hospital staff.
• Patient is harmed due to this medication error.
• More negative impact will be there on the quality of care.

Legal consequences :

• The hospital,nurse and physician on duty , all are resposible for the medication error occured.
• If the patient family members file a case against the hospital and their staff , most probably civil law suit will be filed against them.

General legal actions taken in medication errors:

• Civil actions : Civil actions are commonly filed against physicians in medication error which resulted in harm to patient.In civil law suit , compensation is paid to the family of patient by the physician.
• Criminal charges : These are less commonly filed against physicians in medication error.If at all filed, includes few months of imprisonment, detention at home etc.
• Medical board discipline : When a complaint is given to board by patient family members , board will investigate and do internal enquiry to check whether the physician fault was there or not and the severity and consequences of error were analysed and based on which it will take the disciplinary action. It also has the power to suspend or revoke a physician's license if the event is sufficiently egregious.