Question

A 75-year-old patient at a licensed healthcare provider care center suffered from diabetes, dementia, coronary artery disease, immobile decubitus ulcers (bedsores), and was unable to walk, talk, or feed herself. Her physician prescribed a daily whirlpool bath as a medical treatment for the decubitus ulcers. The facility did not have a whirlpool, so she was given a regular daily bath. A certified nursing assistant prepared a bath for the patient and placed her in hot water that was 138 degrees and that subsequently caused severe burns from which she died three days later. A wrongful death action was brought. Parties settled before trial for $1.5 million. Source: Strine v. Commonwealth of Pennsylvania, et al., 894 A.2d 733 (Pa. 2006). Although the vignette is based on this case, do not consult the case for additional facts. Answer each question based on the facts presented in the vignette. Are all of the elements of negligence present in this case? Discuss the breaches of the standard of care. How could the patient’s death have been prevented? How could a safer environment have been provided as it relates to caring and communication? Does the apology statute apply to this case? Yes or No? Why?

Answer 1

Are all of the elements of negligence present in this case?

YES.The elements of negligence are

• Duty
• Breach of duty
• Direct cause
• Damage/injuries.

All the elements of negligence are present in this case.

1. The old lady was ordered for a whirlpool bath which helps in relaxation of sore joints , body and also improves blood circulation which will help in soothing and healing effect on decubitis ulcers but it was not provided. The unavailability of the therapeutic bath was not informed to the physician . She didnot had concern to give reasonable care to her patient.
2. She is accountable for the care given .The nursing assistant failed to check the temperature of the water(breach of duty negligence)
3. The hot water caused severe burn injuries( damage) and it led to death of the old lady.(direct cause).

Discuss the breaches of the standard of care.

The certified nursing assistant failed to notify physician that whirlpool bath is not available .Being a certified nursing assistant of the state she had unreasonable lack of skill .She didnot provide a safe care. The duty to check the temperature of the hot water before giving bath has not met.The breach of duty caused severe burn injuries .If the nurse had checked the temperature of water, the bruns sustained by the patient would have been prevented. The nurse's negligence led to death of patient.

How could the patient’s death have been prevented?

CNA's failure to inform the unavailability of the whirlpool bath and behaved negligent by failing to check the temperature of hot water before giving bath led to damages and death. If these both of the duties were performed correctly it could have prevented the death of the old lady.

How could a safer environment have been provided as it relates to caring and communication?

Communication is the backbone of the healthcare communication and very important for the safety of a patient .The physician ordered whirlpool bath to improve the blood circulation which may help in healing of bedsores and also as a relaxation therapy for the bedridden patient. The nurse's responsibility is to inform the physician about the situation ( unavailability of whirlpool bath).The patient death occurred because of burns sustained from hot water during bath.

Caring for patients by meeting their needs and also the patient is unable to express her needs because she is unable to talk. So the nurse should work with responsibility as she is fully accountable for the care given.If the nurse have checked the temperature the patient would be alive now.

Does the apology statute apply to this case? Yes or No? Why?

Yes . It is a wrongful death due to nurse's negligence and also claim is settled.