A Sudden Pain
One Monday morning in early 2004 my husband Jerry woke me and said his back was hurting. When the pain became severe we decided to go to the emergency room. At the emergency room, they treated him for the pain with several rounds of narcotics, including injections of morphine and Dilaudid. The emergency room doctor arrived and ordered a CT scan. When the CT scan results came back, the emergency room physician said that it looked as though Jerry was passing a kidney stone. Jerry was admitted to the medical-surgical unit for observation and pain management.
The hospital suggested a urologist, who v
visited us that afternoon. The urologist confirmed that there was a kidney stone but said the CT scan also had shown a small mass within the kidney. He wanted to do an additional test, with dye, to see the mass.
Jerry was given morphine and the painkiller Toradol (ketorolac) by intravenous injection every 4 hours through the night and into the following day. They also set up IV fluids to help wash out the kidney stone.
The next morning, Tuesday, Jerry was supposed to have a CT scan with dye to get a better look at the mass in his kidney. I went to school to prepare lesson plans in anticipation of being away from class. When I returned to the hospital, Jerry told me that they had not done the test because something was wrong. So I found a nurse, who said that Jerry’s blood work had shown his serum creatinine level was rising. They did not want to perform the dye test until these kidney function test results looked better.
Jerry continued to receive Toradol throughout the day even though his pain was well controlled. I asked a nurse if this kind of high creatinine level was normal for a person with a kidney stone. She told me that it was probably caused by the Toradol and explained that nonsteroidal anti-inflammatory drugs like Toradol can cause the creatinine level to rise. She told me Jerry was getting too much Toradol.
This nurse was an RN—a registered nurse—but I did not realize this at the time. The nurses’ badges did not designate whether they were an RN or a licensed vocational nurse (LVN). The attire was the same for all nurses, so I could not distinguish between them. The hospital’s policy was to use RNs only as “resource” nurses. There were only two registered nurses on the floor, and they were not assigned to specific patients. The bedside nurses taking care of the patients were LVNs. So if an LVN needed to give a medication that she was not authorized to give, the LVN had to find a registered nurse who could administer the medication. I did not understand at the time that this was the policy.
When the doctor came to the room on Tuesday evening around 5:30, I mentioned Jerry’s creatinine level and told him what the nurse had said. While the doctor was in the room his three pagers went off at various times, all while we were trying to have a conversation about Jerry. When I brought up the creatinine a second time, he told us he would discontinue the Toradol and restart the IV fluids to get the creatinine level down.
By 7:00 that night they still had not started the IV fluids. When the night shift nurse came in, she told me there had been no order placed for this request. At my insistence, she called the doctor, and later she started the IV and discontinued the Toradol. At that time, Jerry’s pain medication was changed to a Lortab tablet every 4 hours because his pain level was now only about 2 on a scale of 1–10.
On Wednesday morning I dropped by the hospital and then I went on to school. Around noon Jerry called and asked me to come back to the hospital. He said they were trying to explain something to him but he could not understand because the medication was making him feel confused. So I arranged for a substitute teacher for the afternoon and returned to the hospital.
I stayed with Jerry throughout the evening. About 7:15 that evening the bedside nurse (an LVN) came in with medication. Jerry told her he was not going to take it because it was making him feel odd and his pain level was minimal. The LVN told him that he needed to maintain his pain relief regimen, but Jerry refused the Lortab. He told her that if he needed the medication he would let her know. I left the hospital about 8:00 that evening, as our son Jordan had come to visit Jerry. They watched basketball and talked politics until around 9:00 p.m., when Jordan left the hospital.
Jerry was set to go home the next morning. We were just waiting for results of the morning blood test to confirm that his creatinine level had come down so that he could be discharged. Because the CT scan with dye had not been done, Jerry was scheduled for an MRI after discharge because the hospital did not offer open MRI services. His pain was minimal and manageable with Lortab, so the doctor had told Jerry he could leave the hospital to get the MRI and follow up after the doctor’s office had received the images.
Your Husband Is Dead
The following morning, Thursday, January 22, the phone rang at 5:50 a.m. I thought it must be Jerry because when he was away from home he would often call early in the morning to say good morning. The person on the phone told me that my husband had had an emergency and that I needed to come to the hospital immediately. When I asked what had happened, she said there had been an emergency and a urologist was in with him now. She asked how long it would take me to get to the hospital. I said about 5 minutes. I was terrified. She had given me no information about my husband’s “emergency.” I assumed because a urologist was with him that he was passing the kidney stone and that something had happened related to the kidney stone.
I dashed to the hospital and ran up to the second floor where Jerry’s room was. As I entered the waiting area I saw our son. At that moment my heart stopped. A nurse I had never seen before came walking toward me as I started down the hall to Jerry’s room; she took Jordan and me into an empty patient room. The nurse looked at me and said, “Your husband is dead.” I was absolutely stunned. This could not be true. I kept repeating, “No! No!”
A young woman who was standing with the nurse told us that pain medication had been given to Jerry sometime in the early morning hours. She was crying as she told us this. I learned later that she was the new on-call attending physician for the urology group. She had only recently finished her residency. She had never seen Jerry before but had been called to the hospital when the staff discovered that Jerry was dead.
The nurse repeated to me several times, “Your husband died peacefully in his sleep. You can take comfort in that.” At that point, I ran out of that room and into Jerry’s room, and he did look asleep, except that there were tubes inserted into his mouth and I saw a catheter hanging on his bed. The room was nice and neat, and Jerry was lying on his back with his hands on his chest. It all looked surreal.
My shock was so complete that I tried to wake Jerry—tried shaking him—finally collapsing in screams and sobs. The same nurse stood in the doorway and said again, “He looks like he is just sleeping, doesn’t he? Doesn’t he look peaceful?”
The young doctor who had told us about Jerry’s death was gone. I asked again and again what had happened, but we could not get anyone to answer any specific questions. When I asked about the tubing and the catheter, the nurse said they had called a code and that a full resuscitation with intubation was standard procedure. A nurse came into the room some time later and asked if we wanted the tubes removed. I said, “No, don’t change anything.” I did not want anything changed because I did not know what had happened.
During that morning I questioned nurses and the administrator who had come in to talk to us. I kept receiving the same news—that Jerry had died peacefully in his sleep. The administrator asked us about funeral arrangements, and a nurse brought in a release form. I asked about the county medical examiner. Had he been called? When would someone come to begin the investigation? The nurse told me that the medical examiner’s office was “not interested in investigating” Jerry’s death. I was stunned. I asked, “What did you tell them about the cause of his death?”
She replied, “Renal failure.”
Again, I was shocked. I knew for certain that his death was not caused by renal failure. Just a few hours ago, Jerry had been in minimal pain, talking, laughing, and watching basketball. There had never been any mention of renal failure. We later learned that the Harris County medical examiner’s office had no record of a call from the hospital about Jerry’s death. A representative from that office gave a sworn affidavit attesting to “no record of a call concerning Jerry Carswell” received from the hospital.
I told the hospital administrator that I wanted an autopsy. Jerry was supposed to come home, he had no other health problems, he was taking no other medications, and he had been active. The nurse told me that the urologist had already ordered an autopsy. I asked how that worked. Did they do them here or somewhere else? The nurse said they would do the autopsy at a hospital in downtown Houston. I told her that I did not want the hospital where Jerry had died to perform the autopsy, because I wanted an independent autopsy. The nurse replied that an autopsy could cost up to $10,000. At this point I did not care how much it might cost; I just wanted it to be complete so I could find out what had happened. Jordan and I talked this over—we wanted an autopsy that would tell us why Jerry had died.
A nurse brought me the document to request the autopsy. She assured me that the autopsy conducted by the hospital would be “just like” an autopsy I would get from an independent pathologist. There was a place to mark if I wanted a partial autopsy or anything specific. I wrote on the paper, “Complete Autopsy,” and signed it.
At one point the hospital administrator came into the room and announced that it was “time for us to go home.” I told her I wanted to be there when the funeral home transported Jerry’s body out of the hospital. I again stated that I did not want anything removed from Jerry’s body, and I specifically requested that the urine from the catheter bag go to the autopsy. Later, around noon, the administrator came back in and told us the funeral home was on their way to transport Jerry’s body for autopsy. She literally placed her hand on my back and pushed me toward the door of the room. We all then left the hospital and went home. Later, I learned that the funeral home did not arrive at the hospital until more than an hour later.
There are no adequate words to describe what I felt like leaving the hospital, the reality of the cold air when I got outside, of what had just happened inside that building. Jerry was gone. I could not absorb that fact, or that I had just signed for an autopsy when I had never before had any occasion even to think about an autopsy, or the fact that no one at the hospital would tell us anything specific about how Jerry died. There I was, going back home alone—this surely was some terrible nightmare.
Looking for Answers
When I went home, I called friends, and they called friends, and by the next day the Houston Chronicle published a story in the sports section about the loss of this man whom everyone in the area knew. There was an outpouring of response from coaches in the area and from the students Jerry had coached. His death was a great loss to many people.
While we were mourning his loss, Jerry’s body was being transferred to the pathology lab at the hospital in Houston. The autopsy was done there. But it turned out that this hospital was a sister hospital to the one where Jerry had died. It was not the independent autopsy we thought we were getting.
We later found that there are two distinct kinds of autopsy procedures. Clinical autopsies, the kind usually done in hospitals, do not include the same investigative procedures that a forensic autopsy does. Even though a large dose of narcotics had been administered to Jerry prior to his death, Jerry’s autopsy did not include toxicology screening that would have been done by the medical examiner or by an independent pathologist in what is called a forensic autopsy. Jerry’s autopsy was done by a pathologist who testified that he had never done a toxicology screen in an autopsy, not once in his 20+ years of working for that hospital pathology group. The pathologist did not test the urine that remained in the body. The urine bag that I had seen in the hospital room disappeared. A hospital pathologist said the bag was not with the body when it arrived in the lab.
Shortly after Jerry was buried, I went to the hospital and got his records. When I read the report from the emergency room doctor who had been called to the code, it said that Jerry had been found lying across the bottom of the bed as if he had been trying to get up. The urologist’s report said the same thing. This was in direct conflict with what I had been told at the hospital, that he had “died peacefully” in his sleep.
That is the point at which I decided I needed more information. The attending urologist from the hospital helped us get the autopsy report, but he never answered my questions about why there were two conflicting stories. The hospital did not return my calls.
When we received the death certificate, there was no cause of death listed. We still, even now, do not have an official cause of death. The death certificate listed three conditions present prior to death. These had to do with an irritation in the lining of Jerry’s stomach and in the pyloric area, both of which we believe were probably side effects of the Toradol and not underlying conditions; Jerry had no indication of any kind of medical distress other than the kidney stone until we came to the hospital. Ironically, the autopsy report showed no kidney stone on the right side where Jerry’s pain had been. It noted a small stone on the other side still in the kidney. It also noted the small mass and said it “appears confined to the kidney.”
After seeing Jerry’s medical records, I talked with a friend who encouraged me to contact an attorney to see if we could find out what had caused Jerry’s sudden and unexpected death. We then entered a long and difficult legal process that I wish we had not had to do. In that process we discovered a number of issues that were very disturbing.
One key issue was that the amount of the medication Toradol that Jerry had been given was far in excess of the strict limits recommended for this drug. This explained why the drug had such an adverse effect on his kidneys. Another was that the LVN who was administering the Toradol was not allowed by hospital policy to administer this class of drug and did not have sufficient training in the purpose of the drug or its possible side effects, which include adverse effects on the kidneys. Because the RNs were floaters and were not assigned to specific patients, there was no real monitoring or oversight of the bedside LVN nurses.
We also discovered that just before midnight on the night Jerry died, the same LVN had written details in Jerry’s chart about giving pain medication to a knee surgery patient. She had detailed the angle the knee was positioned in and things like that. By the time we saw the records, this information had been lined out. The correction was initialed and dated January 22, the morning of Jerry’s death, indicating to us that Jerry’s LVN had not noticed her mistake during the night that Jerry died. Personnel records showed that this LVN had taken many extra shifts that week—more than twice the hours of any other nurse. I am not sure what mental state she was in the night of Jerry’s death, but she definitely placed the wrong information in Jerry’s record. As part of the correction done after Jerry’s death, she reported that she had administered Lortab to Jerry about 1:00 a.m. We wondered if she could have given him the Lortab and the surgery patient’s medication, too.
Jerry’s records reflect a call to the on-call urologist saying that Jerry had been in level 9–10 pain since 1:00 a.m. At 3:15 a.m., according to the medication record, a nurse—it is unclear which nurse—administered a bolus does of 75 mg of Demerol and 25 mg of Phenergan. In trial, a laboratory technician stated she encountered two nurses coming out of Jerry’s room with a syringe at 5:00 a.m. There is no record of a 5:00 a.m. medication administration, however. When the lab tech entered the room around 5:15 a.m. to draw blood, she found Jerry’s lifeless body.
It was a year before we sought legal recourse, but in the end we felt we had no choice. The legal process was slow and stalled repeatedly for various reasons, including changes in hospital ownership. The hospital was uncooperative, and the judge sanctioned them for spoliation and destruction of evidence. The hospital mounted an unsuccessful challenge against both the sanctions and our requests for evidence. Then the hospital where the autopsy had been done filed for bankruptcy. All told, it took us 5 and a half years to get into a courtroom. When we finally got there, the hospital administrator and nurses denied under oath that they had ever spoken to Jordan and me about the funeral home or the autopsy. This was proven not true by funeral home documents and by the testimony of other people who had been present that morning.
The jury vote fell two votes short of the number required for a negligence verdict in Texas. Several jurors later stated to my attorney that because there was no official cause of death, they felt there were too many unanswered questions to make a determination, even though they felt that the hospital had caused Jerry’s unexpected death. The jury voted in our favor on the post-mortem fraud, finding that the statements hospital personnel made to me had led me to believe the autopsy would be “complete” and would be an investigation into the cause of Jerry’s death. In a unanimous vote, the jury added punitive damages as a punishment for what they considered the hospital’s egregious misconduct.
Conclusion
One of the most shocking things to come out of the lawsuit occurred during the pathologist’s deposition. He stated that he had removed Jerry’s “whole heart” and retained it in his lab. The pathologist did not request permission or inform me that he had retained Jerry’s heart and stored it in an unmarked plastic bucket in the pathology lab. We had buried Jerry without his heart, a disturbing and painful realization that haunts us still.
I became convinced that Texas needed a state-promulgated consent form for autopsy so that families could be informed about their rights concerning autopsies. In addition to Jerry’s heart being removed without our knowledge, Jerry’s death met three of the six conditions that Texas law specifies as requiring a death investigation or forensic autopsy. I went to my state representative and asked him to sponsor a bill that would require hospitals to use an “informed consent” for autopsy, a document that would inform families of their legal rights. The Jerry Carswell Memorial Act passed the Texas legislature in 2011, and now every medical institution in the state must use this form when they ask for permission to do an autopsy. The form lists the conditions under which state law says there must be a death investigation and states that the patient’s family has the right to request an independent pathologist to attend or perform the autopsy (Figure 15-1).
Questions
What do you think Jerry Carswell’s nurses and doctors could have done to protect against the adverse outcome that occurred?
What steps do you think the hospital should have taken to avoid the suspicions and antagonisms that immediately arose between this family and the hospital?
Consider the legal process in this lengthy case from both the hospital’s and the family’s point of view. Is this the best way to handle this situation?
Should more autopsies be mandated? Read some of the literature on autopsy findings and discuss whether you think a high autopsy rate is a good idea.
Look up the differences between forensic and clinical autopsies. Should toxicology screening be required in hospital autopsies?
Which of the core competencies for health professions are most relevant for this case ?why?
In: Nursing
Sophia began her small family child care business (licensed for up to 8 children) in 2004. Her business is located in a lower to middle-class, diverse neighborhood in San Francisco. Soon after Sophia opened her program she reached full capacity and after several months she began a waiting list. By 2007, she was averaging three calls per month for child care spaces that she didn't have available. Sophia began to think about expanding because the demand for her child care services was clear, and because she knew that many of the low-income families were able to use state subsidies in the form of parent vouchers in order to pay for such services. Also, since Sophia already had a part-time teacher working for her she knew that by expanding she could promote that teacher to a full-time position and open up a new part-time position in her program. Most of all, Sophia enjoyed the personal satisfaction of knowing that she helped mold the children in her care and that she helped their parents create a good life for their kids. As a professional, this is her highest reward, and she believed that through expanding her program, she would be able to succeed in helping even more children and families in the community.
1. Please answer all the questions below:
• What is the ultimate objective of the expansion?
• Is there a clear market demand for the additional services?
• What materials and equipment are needed to make the expansion a success?
• What new costs or increased costs will the operating budget require? For example, how will staff salaries change, what additional food expenses will result, and what extra services might she offer for her new families?
• How will she market her expanded services?
• How should she finance the project in order to pay for the expansion costs?
In: Nursing
The Nellie Mae organization found random sample of 100 students taken in 2004, average credit card balance = $2169. Suppose sample standard deviation of the credit card balances = $1000. Perform a test to test if the average credit card debt exceeds $2000.
a) what is the population, variable, parameter
b) does CLT hold
c) state hypothesis, H0 = , HA :
d) calculate test stat
e) find p-value range
f) make decision at .05 significance level and write conclusion.
In: Statistics and Probability
Researchers Hill and Barton used data from the 2004 Olympics to test whether one uniform color (red or blue) gave athletes a competitive advantage. In the sports of boxing tae kwon do, and wrestling, athletes are randomly assigned either a red or blue uniform. They found that out of 457 matches, the competitor in red won 248 times.
Let pi be the long-term probability that an Olympic match of boxing tae kwon do, or wrestling is won by the athlete wearing a red uniform. Then we want to test
H0:π=0.50
Ha:π≠0.50
a. Is a normal approximation for the null distribution appropriate?
A. No
B. Yes
b. Compute a theory-based p-value for this study. If a normal approximation is appropriate, then use a normal approximation. If not, then use a binomial distribution.
c. What is your conclusion?
A. There is moderate evidence that the long-term
probability of winning for Olympic athletes in red uniforms is not
0.5.
B. There is strong evidence that the long-term
probability of winning for Olympic athletes in red uniforms is not
0.5.
C. It is plausible that the long-term probability
of winning for Olympic athletes in red uniforms is 0.5.
In: Statistics and Probability
|
In December 2004, Mary Lazarro, a 41-year-old mother of two, was admitted to Finger Lakes Community Hospital because of numbness of the chin and lower lip. Two week prior to admission, she noted a prickling sensation like “pins and needles” at the right corner of her mouth. The sensation extended bilaterally to the lower lip and to her chin. Neurologic examination revealed only a superficial hypoesthesia of the chin and lower lip (numb chin syndrome). There was not clinical evidence of palpable regional lymph nodes or other systemic and neurologic abnormalities. X-rays and a CT scan revealed no abnormalities in the jaw, neck, or pharynx. The numbness and hypoesthesia spontaneously disappeared gradually over a few weeks time. 1) The chapter reviews the organization of the human nervous system. From this outline, describe the specific “part” of the nervous system that is affected. 2) Using what you know about the neuroanatomy of this affected region, describe what nerve is involved (hint: this is a complex nerve, so be specific regarding the part that is affected) a. ORIGIN : Where does the nerve originate from? b. COURSE: What is the course of this nerve (what structures does it pass by and/or through?) c. FUNCTION: What is the normal function of this nerve? |
In: Anatomy and Physiology
PLEASE SHOW CALCULATOR STEPS INCLUDING WHAT YOU INPUT FOR THE TESTS Just before the 2004 Democratic convention, Rasmussen Reports polled 1500 likely voters at random and found that 705 favored John Kerry. Just after the convention, they took another random sample of 1500 likely voters and found that 735 favored Kerry. Did Kerry’s favorability rating increase after the national convention? Use a significance level of a = 0.05.
a) Give the name of the hypothesis test that would be appropriate for this situation. (1 point)
b) State the hypotheses in symbols. (2 points)
c) Use your calculator to perform the appropriate hypothesis test and report the test statistic and p-value. Be sure to write out what you entered in your calculator. (3 points)
d) Make a sketch of the test distribution. Be sure to label the test statistic and p-value. (2 points)
e) Write a full conclusion for this test in the context of the problem. (2 points)
f) Find a 90% confidence interval for the difference in John Kerry’s favorability rating before and after the convention. Do not make these calculations by hand. Instead, use the correct command in your graphing calculator and write out what you entered. (3 points)
g) Does this confidence interval support your conclusion in part (e)? Explain. (2 points)
In: Math
Brief the following case using the IRAC method.
Issue:
Rule:
Application:
Conclusion:
On February l, 2004, CBS, the television network, presented a
live broadcast of the National Football League's Super Bowl
XXXVIII, which included a
halftime show produced by MTV Networks. Both CBS and MTV were
divisions of Viacom Inc. at the time. Nearly 90 million viewers
watched the show,
which featured recording artists Janet Jackson and Justin
Timberlake. Jackson and Timberlake performed his popular song
"Rock Your Body " as the show's
finale. Their performance involved sexually suggestive choreography
with Timberlake seeking to dance with Jackson and she alternating
between accepting and
rejecting his advances. The performance ended with Timberlake
singing, "gonna have you naked by the end of this song,
" and simultaneously tearing away part
ofJackson 's bustier. CBS had implemented a five-second
audio delay to guard against the possibility of indecent language
being transmitted on air, but it did
not employ similar precautionary technology for video images. As a
result, Jackson's bare right breast was exposed on camera
for nine-sixteenths of one second.
Jackson 's exposed breast caused a sensation and
resulted in a large number of viewer complaints to the Federal
Communications Commission. In response, the
FCC issued a letter of inquiry asking CBS to provide more
information about the broadcast. CBS issued a public statement of
apology for the incident. CBS
stated that Jackson and Timberlake's wardrobe stunt was
unscripted and unauthorized, claiming CBS had no advance notice of
any plan by the performers to
deviate from the script. After its review, the FCC determined CBS
was liable for a forfeiture penalty of $550,000 on several grounds,
including that under the
doctrine ofrespondeat superior, CBS was vicariously liable for the
willful actions of its employees, Jackson and Timberlake. CBS asked
the Third Circuit
Court ofAppeals to review the FCC decision.
Scirica, Chief Judge
The respondeat superior doctrine provides that "[a]n
employer is subject to liability for torts committed by employees
while acting within the scope of their
employment." Restatement (Third) ofAgency 2.04 (2006)
But even though the respondeat superior doctrine may apply in
this context, it is limited to the conduct of employees acting
within the scope of their
employment. Determining whether CBS may be liable under respondeat
superior first requires selection of the applicable legal standard
for differentiating an
"employee" from an "independent
contractor."
In Cmty. for Creative Non-Violence v. Reid, 490 U.S. 730 (1989),
the Court set forth a test for determining who qualifies as an
"employee" under the common
law:
In determining whether a hired party is an employee under the
general common law of agency, we consider the hiring
party's
right to control the manner and means by which the product is
accomplished. Among the other factors relevant to this
inquiry
are the skill required; the source of the instrumentalities and
tools; the location of the work; the duration of the
relationship
between the parties; whether the hiring party has the right to
assign additional projects to the hired party; the extent of
the
hired party's discretion over when and how long to work;
the method of payment; the hired party's role in hiring and
paying
assistants; whether the work is part of the regular business of the
hiring party; whether the hiring party is in business; and
the
tax treatment of the hired party.
While establishing that all of these factors are relevant and
that "no one of these factors is determinative,"
Reid did not provide guidance on the Page 996
relative weight each factor should be assigned when performing a
balancing analysis. Accordingly, all of the Reid factors are
relevant, and no one factor is
decisive, but the weight each factor should be accorded depends on
the context of the case. Some factors will have "little or
no significance in determining
whether a party is an independent contractor or an
employee" on the facts of a particular case. In the
present case, the FCC erred by failing to consider several
important Reid factors when determining whether Jackson and
Timberlake were employees of CBS. And rather than balancing those
factors it did consider,
the Commission focused almost exclusively on CBS's right of
control over the performers.
Only three factors weigh in favor of a determination that
Jackson and Timberlake were employees of CBS. First, CBS is in
business, which increases the
possibility that it would employ people. Second, CBS regularly
produces shows for national broadcast in the course of its
business. Both factors are relatively
insignificant on balance. Third, and most significant to its
argument, is the factor the FCC focused on in its orders:
CBS's right to control the manner and means
by which Jackson and Timberlake accomplished their Halftime Show
performance. As the FCC contends, CBS, through its corporate
affiliates, supervised the
Halftime Show and retained the right to approve all aspects of the
show's performances. But it is undisputed that
CBS's actual control over the Halftime Show
performances did not extend to all aspects of the
performers' work. The performers, not CBS, provided their
own choreography and retained substantial latitude
to develop the visual performances that would accompany their
songs. Similarly, as the FCC notes, CBS personnel reviewed the
performers' selections of set
items and wardrobes, but the performers retained discretion to make
those choices in the first instance and provided some of their own
materials.
CBS's control was extensive but not determinative of
employment. Even though a principal's right to control is
an important factor weighing in favor of a
determination that an employment relationship existed, it is not
dispositive when considered on balance with the rest of the Reid
factors. Of the remaining
factors significant on the facts here, all are strongly indicative
of Jackson and Timberlake's independent contractor status.
First, it is undisputed that both
Jackson and
Timberlake were hired for brief, one-time performances during the
Halftime Show; CBS could not assign more work to the performers.*
Second, Jackson and
Timberlake selected and hired their own choreographers, backup
dancers, and other assistants without any involvement on the part
of CBS.
Third, Jackson and Timberlake were compensated by one-time,
lump-sum contractual payments and "promotional
considerations" rather than by salaries or
other similar forms of remittances, without the provision of
employee benefits. Fourth, the skill required of a performer hired
to sing and dance as the headlining
act for the Halftime Show—a performance during a Super Bowl
broadcast, as the FCC notes, that attracted nearly 90 million
viewers and was the highest-rated
show during the 2()()3-()4 television season—is substantial even
relative to the job of a general entertainer, which is itself a
skilled occupation.
Also weighing heavily in favor of Jackson and
Timberlake's status as independent contractors is
CBS's assertion in its briefs, which the FCC does not
refute, that
it paid no employment tax. 1--1ad the performers been employees
rather than independent contractors, federal law would have
required CBS to pay such taxes.
Finally, there is no evidence that Jackson, Timberlake, or CBS
considered their contractual relationships to be those of
employer-employee. In Reid, the Court
incorporated the Restatement, describing it as "setting
forth a nonexhaustive list of factors relevant to determining
whether a hired party is an employee"
under the common law of agency. Among the factors not explicitly
listed in Reid, but included in the Restatement, is the
parties' understanding of their
contractual relationship. See Restatement (Third) ofAgency 7.07
cmt. f (including as an explicit factor in determining employment
status "whether the
principal and the agent believe that they are creating an
employment relationship"). Although the Commission did not
inquire into this factor, it should have
been a significant consideration in this case. Under the
FCC's rationale, band members contracted to play a one-song
set on a talk show or a "one-show-only"
televised concert special presumably would be employees of the
broadcaster. These performers—who frequently promote their work
through brief contractual
relationships with media outlets—would be
"employees" of dozens of employers every year.
Accordingly, it is doubtful that either the performers here
or
CBS believed their contracts created employment relationships.
On balance, the relevant factors here weigh heavily in favor of
a determination that Jackson and Timberlake were independent
contractors rather than employees
of CBS. Accordingly, the doctrine of respondeat superior does not
apply on these facts.
FCC order vacated in favor of CBS.
In: Operations Management
Here is a series of address references given as word addresses: 18, 19, 27, 16, 21, 0, 64, 48, 19, 11, 19, 22, 4, 27, 6, and 27. Assuming a direct-mapped cache with 16 one-word blocks that is initially empty, label each reference in the list as a hit or a miss and show the final contents of the cache.
In: Computer Science
It was published that children who have longer first names tend to achieve higher grades (%) in elementary school. For example, Zai (short name, only three letters) may achieve a lower grade than Kabiralina (much longer name, ten letters). A study was conducted to investigate the influence of name length on grades from a local sixth grade class. Is there such a relationship?
| NAMES | GRADES |
| Aaralyn | 76 |
| Baldasarre | 72 |
| Cai | 84 |
| Daenerys | 71 |
| Ean | 74 |
| Famke | 79 |
| Gainella | 73 |
| Hakizimana | 73 |
| Ichnoyotl | 74 |
| Jadzia | 88 |
| Kabiralina | 83 |
| Lakshmina | 75 |
| Maconaquea | 73 |
| Nahuati | 87 |
| Ofek | 77 |
| Paitalyi | 74 |
| Qi | 87 |
| Raghnallia | 81 |
| Sada | 73 |
| Tabananica | 79 |
| Ulfah | 89 |
| Vadim | 84 |
| Wahmenita | 88 |
| Xanthusia | 79 |
| Yael | 85 |
| Zagiri |
81 |
The appropriate test for this problem is:
a. correlation
b. regression
c. multiple regression
The obtained statistic is:
a. - . 56
b. - .65
c. - .53
d. - .35
The associated p value is:
a. .168
b. .861
c. .038
d. .083
Decision is:
a. reject the null
b. retain the null
Conclusion is:
a. names are significantly correlated with grades in a positive direction
b. names are significantly correlated with grades in a negative direction
c. names are significantly correlated with grades in both directions
d. no conclusion can be drawn
In: Statistics and Probability
The data file ExamScores shows the 40 students
in a TOM 3010 course exam scores for the Midterm and Final exam. Is
there statistically significant evidence to show that students
score lower on their final exam than midterm exam? Provide the
p-value for this analysis.
| Student ID # | Midterm | Final |
| 56065 | 97 | 64 |
| 79499 | 95 | 85 |
| 59716 | 89 | 72 |
| 83504 | 79 | 64 |
| 77735 | 78 | 74 |
| 57760 | 87 | 93 |
| 78204 | 83 | 70 |
| 81177 | 94 | 79 |
| 54398 | 76 | 79 |
| 79829 | 79 | 75 |
| 62759 | 83 | 66 |
| 60967 | 84 | 83 |
| 82719 | 76 | 74 |
| 59420 | 82 | 70 |
| 69717 | 85 | 82 |
| 67553 | 85 | 82 |
| 67762 | 91 | 75 |
| 60851 | 72 | 78 |
| 81587 | 86 | 99 |
| 82947 | 70 | 57 |
| 62831 | 91 | 91 |
| 79864 | 82 | 78 |
| 67627 | 73 | 87 |
| 70270 | 96 | 93 |
| 54637 | 64 | 89 |
| 65582 | 74 | 81 |
| 64976 | 88 | 84 |
| 66027 | 88 | 63 |
| 77528 | 60 | 78 |
| 68129 | 73 | 66 |
| 56098 | 83 | 84 |
| 75695 | 85 | 85 |
| 66311 | 82 | 85 |
| 72678 | 79 | 84 |
| 80248 | 75 | 59 |
| 63594 | 82 | 62 |
| 53448 | 88 | 91 |
| 53454 | 86 | 83 |
| 59507 | 83 | 80 |
| 57192 | 70 | 76 |
In: Statistics and Probability