What are 3 potential legal issues and 3 solutions that must be discussed and analyzed in this passage?
A 40-year-old female patient requested examination by a family physician after she discovered her husband had hidden from her that he had multiple STDs, including venereal warts, caused by human papillomavirus (HPV). On the patient’s first visit, a pap smear and STD tests were performed. The STD tests came back positive for both HPV and chlamydia. In addition, the pap smear showed cervical abnormalities.
The patient was referred to a specialist for follow-up care, and a biopsy confirmed the presence of cervical cancer. Both the specialist and the family physician reached out to the patient to discuss the results. Additionally, the family physician reported the chlamydia result to the local health department.
After ignoring multiple calls and messages, the patient returned the calls of both physicians and informed them she would treat the chlamydia but was not interested in pursuing any treatment for the cancer. Both physicians were highly uncomfortable with this decision, as the patient was only 40 and the cancer was treatable. They contacted a local judge to discuss options for making the patient pursue treatment because they felt the she was making the wrong decision.
Simultaneously, a medical assistant in the family physician’s office noticed the patient’s biopsy results come through on the fax machine. The medical assistant revealed information about the patient’s condition to some of her friends, all of whom knew the patient from church. The patient found out that her medical information had been disclosed when her name ended up on her church’s prayer list in the weekly bulletin, listing her as battling cervical cancer.
The patient was eventually able to identify the source of the leak, and she subsequently filed a HIPAA privacy complaint with the Office of Civil Rights of the U.S. Department of Health and Human Services naming the medical assistant and the family physician’s office.
The family physician’s office learned of the privacy complaint and promptly sent the patient a letter terminating her from any future services.

Spacemakers of America, Inc., hired Jenny Tripplet as its bookkeeper. Pacemakers did not inquire about any prior criminal record or conduct a criminal background check of Triplett. If it had taken those steps, it would have discovered that Triplett was on probation for 13 counts of forgery and had been convicted of theft by deception. All convictions were the result of Triplett forging checks of previous employers.

Spacemakers delegated to Triplett sole responsibility for maintaining the company’s checkbook, reconciling the checkbook with monthly bank statements, and preparing financial reports. Triplett also handled the company’s accounts payable and regularly presented checks do Dennis Rose, the president of Spacemakers, so he could sign them.

Just weeks after starting her job at Spacemakers, Triplett forged Rose’s signature on a check for $3,000 made payable to her husband’s company, Triple M Entertainment Group, which was not a vendor for Spacemakers. By the end of the first full month of employment, Triplett forged 50 more checks totaling approximately $475,000. All checks were drawn against Spacemaker’s bank account at SunTrust Bank. No one except Triplet reviewed the company’s bank statements. Subsequently, a SunTrust employee visuasilly inspected a $30,670 check She became suspicious of the signature and called Rose. The SunTrust employee faxed a copy of the check to Rose, which was made payable to Triple M. Rose knew that Triple M was not one of the company’s vendors, and a Spacamekrs employee reminded Rose that Triplett’s husband owned Triple M. Rose immediately called the police and Triplett was arrested.

Spacemakers sent a letter to SunTrust Bank, demanding that the bank credit $523,106 to its account for the forged checks. The bank refused, contending that Spacemaker’s failure to provide the bank with timely notice of the forgeries barred Spacemaker’s claim. Spacemakers sued SunTrust for negligence and unauthorized payment of forged items. The trial court granted SunTrust’s motion for summary judgment. Pacemakers appealed.

Using IRAC, how should this case have been decided and why? Please, do not copy from google. I need original answer.

A Near-Death Experience

I remember everything that happened that day before the surgery was supposed to take place. I remember rolling into the preholding area. I remember telling the anesthesiologist that I was very uncomfortable about the block. He told me not to worry, that he had done it a hundred times. He will tell you now that he has never said that again. In fact, he will tell you that when he saw the list of things I wanted, his immediate reaction was, “She is going to be a pain.” Today, his thinking has changed to, “This is a patient who has some experience and we need to have a conversation before the surgery.” So his practice has changed because of what happened that day.

From the beginning, I had a bad feeling about this surgery. I had signed many consent forms, but this was the first time I had looked at a form and had the word “death” pop out at me. I don’t know why I felt that way, but when I think back I would say to any patient, “If you have a bad feeling, honor that feeling. It does not matter how crazy you feel, honor that bad feeling.”

The last thing I remember is saying goodbye to my husband. Then we went into the preoperative holding area, and that was where they injected the block. The procedure consisted of going in past the blood vessels into the nerve. To do this they have to pull back on the needle; if there is no blood then they are sure they are into the nerve. But when the anesthesiologist pulled back on the needle there was no blood, so he put the medication in, and apparently it went into the blood vessel anyway. What they think happened was that he did not get any blood because it was a broken-down vessel. Bupivacaine is a cardiotoxic drug and within a minute I had a grand mal seizure followed by a full cardiac arrest. They called a cardiac code and started advanced cardiac life support right away, but after 15 minutes I was still unresponsive.

Luckily for me, there just happened to be a doctor there who had experience with this. He knew that the only way to save my life would be to get me onto cardiac bypass right away. Again, things were in my favor that day: there was a cardiac suite already prepared for another patient, with a cardiopulmonary bypass machine primed and ready. They bumped the other patient and within 35 minutes they had opened my chest and had me hooked up to a cardiopulmonary bypass machine so that the medication could be flushed out of my system.

My husband was not even out of the main lobby before I had the cardiac arrest. He got a phone call from the orthopedic surgeon who had stood by in horror watching the whole incident unfold. The surgeon said, “Mr. Kenney, there has been a problem with the anesthesia. We had to crack your wife’s chest; you need to come in.” My husband just dropped the phone and immediately returned. My husband didn’t know where to go, but a woman from admitting recognized him and brought him into a room. He was left alone in a small room until somebody came to get him. I think about that now. Somebody should have been with my husband.

The anesthesiologist and orthopedic surgeon waited for a while before they came to talk to him. As soon as they opened the door my husband physically went after them. He said, “What have you done to my beautiful wife?!” The orthopedic surgeon’s reply was, “It doesn’t look good. We don’t know what the outcome is going to be.”

When I woke up I was on a ventilator in the intensive care unit. No one wanted to talk about what had happened. Someone told me I had had an allergic reaction to the anesthesia. I knew intuitively that was wrong, so right away, as I lay there in the hospital, I felt unsafe and untrusting. That was not a good mental state to be in after what I had been through. My husband did not want to leave my side and did not want anybody near me; I’m sure he was marked by the staff as a difficult family member. I found out years later that they did not ever ask him to leave. They actually changed their practice because they saw that my husband’s voice helped calm me down. I was the first patient to change this practice.

I remember worrying about my children. There was no support for any of my family members. You could see that the staff felt bad for me, but nobody was talking. My orthopedic surgeon could barely look at me. I remember writing a note asking if he had replaced my ankle. He shook his head and looked down. It took me a good week to grasp that my ankle had not been replaced.

I felt abandoned. I had a rewired chest, broken ribs, and I looked as though I had been beaten up. I remember taking that first shower and having somebody wash me because I could not do it and feeling the most vulnerable I had ever felt in my life. I got my chart before I left the hospital and it said right on the front, “Allergy to PENICILLIN and BUPIVACAINE.” That was the route they were going.

Alone at Home

When I left the hospital, I received instructions on caring for my incision and information about a visiting nurse. That was all. I never got a phone call. All I got was a bill. I had had many day surgeries when they would call me the next day and ask how I was doing. This time they almost killed me and I didn’t even get a call.

A week after I got home I received a letter from the anesthesiologist, Dr. van Pelt. I did not know that he had tried to see me several times in the hospital, but that multiple things had stopped that from happening. In the letter he said he was sorry for what had happened and that he believed in open and honest communication. He gave me his home telephone number and cell number. I had no idea that what he was doing was so ahead of the time. My feelings at the time were that this was damage control. I filed the letter, and did not think about it for a long time.

When I got home, Christmas was coming. My kids were all still reacting to what had happened. I was trying to take care of their needs, and I was physically very limited. It was a slow recovery. At the time, I coped by focusing on being thankful to be alive and taking care of my family.

A couple of months later I was feeling better physically. My family and friends thought I had moved on, but I know today that I had not yet processed my emotions. Then, while at a wake for a 14-year-old child, I began to feel guilty. I felt guilty that I got to live and this child had died. It was like the floodgate opened, and every feeling I had been pushing down just came out. I began crying and felt as though I was never going to stop. I remember crying over folding towels. I just felt isolated and alone for months.

I needed a cortisone shot in my right ankle due to severe pain because I had not had the ankle replaced. I made an appointment to see my orthopedic surgeon. I went in and told him that I thought we should talk about what had happened. His entourage left the room and he told me what the day was like for him.

He said, “That day is burned in my memory like the birth of my children, although those were joyful occasions and this was not. Linda, you are a miracle.” By that time everybody was telling me I was a miracle and I did not believe it. He said, “No, Linda, you are a miracle from God,” and he began to cry.

My first reaction was, “What? What are you doing?” But then compassion came over me and I looked at him in a different light. I felt bad for him. It was the first time that anybody had showed me that they cared and that this had had an effect on them, too. As the patient, I needed this. It really made me feel better to see this reaction, but almost at once he stopped the story and would not finish. He got up, walked to the door, and left.

A few days after this meeting I called the hospital to ask if there were other patients I could talk to who had gone through this same thing. I knew I could not be the only one and I needed others to talk to. They never called me back. Months later I called my orthopedic surgeon again and asked whether he thought it would be reasonable for me to invite Dr. van Pelt for coffee. That was when I found out that Dr. van Pelt was no longer in Boston. I felt as though the floor had dropped out from under me. I thought I had missed the opportunity to ever hear the anesthesiologist’s perspective and get closure on our shared event.

Luckily for me, the orthopedic surgeon was very proactive. He reached out to the head of anesthesia department, who contacted Dr. van Pelt. This ultimately led to my phone conversation with Dr. van Pelt, which was wonderful for me because I got to hear how affected he was. I felt as though I finally had gotten to hear the truth from somebody.

I was the first person who had asked him how he was doing. This struck me as so odd. Eventually I met other people who had been on the code team and all they could do was cry. I remember meeting a nursing supervisor who had been taking care of the patient next to me and I told her I often wondered how the other patients going into surgery dealt with seeing this scene unfold right in front of their eyes. She said that for the people who stayed overnight, she went up to see them in their rooms. She took it upon herself to do this all on her own.

I called the hospital and told them that I could not read the writing in the chart, but that I would like to know who everybody was on my code team because I wanted to write them a letter. It was coming up on my 1-year anniversary and I really wanted to thank them for doing their job. I knew that for them it was just their job, but I wanted to articulate how this had affected my family and me and what it meant to us. I never got a phone call back. I have been told that they were just waiting for the lawsuit. The culture at the time was not to speak to anybody involved in a serious adverse event, but I did not know this.

Moving Forward

After a year I wrote a letter to the administration. I said that patients left their facilities all the time after something had gone wrong and asked why we were not supporting them. I offered to help them make the change. I received a letter back a couple of months later. It was very cold and written in legal terms. It made me so angry, I wanted to lash out and hurt them back. I remember thinking, “Now I know why patients sue!”

Then, finally, nearly 2 years after the event, Dr. van Pelt and I met. I was finally able to put a face to the man who was part of an event that had such an impact on my life. We had shared this extremely emotional event and I didn’t even know what he looked like. By this time I had met a number of clinicians and I believed the system had failed us both. I wanted to change that. I remember telling him I wanted to start an organization, although at the time I had no idea what it would look like. MITSS—Medically Induced Trauma Support Services—had a brainstorming brunch in April of 2002, and Dr. van Pelt was one of the many invited guests. This was where we developed the mission of MITSS and ideas for how we would carry it out. Dr. van Pelt was one of the first board members of MITSS.

I was so naïve; I really thought that if I started this organization all the hospitals would send us the people who needed our support. I was so wrong. Three years to the day after my adverse event, I scheduled an appointment with the risk manager of the hospital. I had MITSS brochures and I was going there to see if she would give them to all her patients and family members. I left early, all ready for the meeting, and after I left she called the house canceling the appointment. So can you imagine the look on her face when I showed up? But we have become good friends, and she tells me now that they did not know what to do. They did not know what I wanted. They assumed I wanted something, but all I wanted was to be part of a solution. They could not comprehend that. It has taken years for me to build credibility with this hospital. What struck me was that if we are not acknowledging that these events happen, not doing disclosure or apology, then how can we get to the support piece? It has been a journey. I am now starting to see some progress, but it has been slow.

The institution finally made changes and promised to put our brochures throughout the hospital. But when I would go in, I would find our brochures on the shelves in the closets. Then Dr. van Pelt and I had our pictures on the front page of the Wall Street Journal and suddenly it was a different game. After this publication, I had the opportunity to meet with the hospital, and we were given office space at the hospital. Once I began to learn what the challenges were for the medical community we could look for solutions together, because sometimes they just didn’t see them. They needed the patient’s perspective. It has been a rewarding partnership. I wish people would take the opportunity to embrace their patients when things go wrong because amazing things can happen.

Conclusion

Seven years after the incident described in this chapter, Linda Kenney had her long-postponed ankle replacement surgery. While every effort was made to allay her and her family’s fears before surgery, postoperatively she developed a surgical site infection that required rehospitalization and intravenous vancomycin antibiotics. After more years of acute issues and breakdown in the replaced ankle, Linda finally had the ankle replacement removed and a total ankle fusion in 2014. Her nonprofit organization, MITSS, has continued to grow during this time. It is now entirely consumer-led and is a leading source of information on supporting patients and healthcare professionals following medical harm.

Questions

1. How much of a problem do you believe the policy of not disclosing errors to patients might be? Can you envision circumstances in which this would create ongoing problems for patients and their families?

2. What adverse effects have you seen on clinicians who were involved in a medical error? What do you think could be done to alleviate these adverse effects?

3. Research some of the full-disclosure programs that have been developed and discuss their major components. What barriers do you see to provider disclosure following error? How do full-disclosure programs overcome the barriers to transparency that exist on both sides?

4. Much of this story is a lack of compassion in health care. Do you think there are forces that discourage compassion in day-to-day dealings with patients? If so, how do you think they could be overcome?

5. Which of the core competencies for health professions do you think are most relevant for this case? Why?

(Tragedy of the Commons) Canterbury is a small pastoral town with a grassy area known as the “commons.” The town’s two farmers may freely graze their cattle on the commons. In the spring each farmer simultaneously and independently buy (identical) cattle for $10 a head. The farmers must send their cattle to the commons during the spring and summer to feed and fatten them up. At the end of summer the cattle are sold at the market price of $1 per hundred pounds. (The farmers are price-takers in the larger cattle market.) The problem is that the commons is a small area that can only feed so many cattle before the grazing becomes poor. To capture this idea, let Q be the total number of cattle sent to the commons. The total weight (in hundreds of pounds) of all the cattle at the end of the season is given by W(Q) = 100Q − 10Q^2 , so that weight of a single cow is W(Q)/Q = 100 − 10Q. Let qi be the number of cattle farmer i buys in the spring and sends to the commons. Assume that a farmer can send a “fractional” cow so that qi can be any number greater than or equal to zero. (You can think of this as the farmer sending the cow to the commons for only a fraction of the season.) Naturally, Q = q1 + q2. Thus, the payoff functions are u1(q1, q2) = (100 − 10q1 − 10q2) q1 − 10q1 and u2(q1, q2) = (100 − 10q1 − 10q2) q2 − 10q2.

(a) Write the game in normal form.

(b) Find farmer 1 and 2’s best response function. It’ll help to notice that the game is symmetric.

(c) Find the Nash equilibrium number of cattle each farmer sends to the commons (i.e., head of cattle purchased): (q*1 , q^2 ).

(d) Show that the equilibrium is inefficient because too many cattle are sent to the commons in equilibrium. That is, show that q*1 + q*2 exceeds the quantity that would maximize the joint payoff. (The joint payoff is (100Q − 10Q^2)− 10Q = 90Q − 10Q^2 .)

(e) What is the intution behind part (d)? Can you think of other contexts, possibly including ones we covered in class, to which the same type of analysis applies? That is, where there is "too much" of an activity in equilibrium

Question: Describe the various methods of solving linear systems. With which method of solving linear systems are you most comfortable, and why?

Hint: First, define a linear system, and give an example. Then, discuss the methods, and show the steps to solve your example. Finally, talk about advantages and drawbacks of each method.

"Real-Life" Relationship: Any relationship where we have a fixed cost and variable cost can be represented by a linear equation.

For instance, the cost of a rental car from Hertz might be $100 plus $0.70 per mile, while Enterprise might charge $80 plus $0.80 per mile. We can solve the following system to find out when the cost is the same (c = cost, m = miles driven)

c = 0.7m + 100 (Hertz)

c = 0.8m + 80 (Enterprise)

It turns out that they are equal when the mileage is m = 200.

Challenge 1: Given two lines in standard form, how can you quickly decide if they have the same slope, simply by using ratios of y and x coefficients?

Challenge 2: What is a quick way (without finding the slope or solving for y) to decide whether the following system has a solution?

2x + 3y = 4

2x + 3y = 5

The production of ethylbenzene, a very popular industrial chemical, is carried out reacting benzene with ethylene in liquid phase. This reaction takes place in a series of reactors that involve multiple side reactions and intermediates. Ethylene, being the limiting reactant, is used up first and hence a considerable amount of benzene remains unreacted. From one of the reactors in the series, the exit stream is a mixture of this unreacted benzene (1), an intermediate – toluene (2), and the product ethyl benzene (3).

It is desirable to separate this liquid mixture before sending the components to the next series of reactors/process steps. So 100 mol/min of this mixture is flashed from 200 mm Hg and 50 °C to 100 mm Hg. If the mole fraction of benzene and toluene are 40% each when the mixture enters the flash distillation unit, determine if the mixture will flash completely, partially, or not at all. Assume ideal gas and ideal solution behavior for the vapor phase and liquid phase, respectively. If the mixture does flash partially, determine the composition and molar flow rates of the equilibrium streams exiting the reactor. Show all calculations by hand using your preferred method for solving simultaneous equations. Alternatively, you may use Solver (Excel) but this must be accompanied by a printout of a neatly formatted Excel sheet showing your equations and constraints.

Future Value of an Annuity

Find the future value of the following annuities. The first payment in these annuities is made at the end of Year 1, so they are ordinary annuities. (Notes: If you are using a financial calculator, you can enter the known values and then press the appropriate key to find the unknown variable. Then, without clearing the TVM register, you can "override" the variable that changes by simply entering a new value for it and then pressing the key for the unknown variable to obtain the second answer. This procedure can be used in many situations, to see how changes in input variables affect the output variable. Also, note that you can leave values in the TVM register, switch to Begin Mode, press FV, and find the FV of the annuity due.) Do not round intermediate calculations. Round your answers to the nearest cent.

1. $200 per year for 10 years at 8%.

   $   

2. $100 per year for 5 years at 4%.

   $   

3. $200 per year for 5 years at 0%.

   $   

4. Now rework parts a, b, and c assuming that payments are made at the beginning of each year; that is, they are annuities due.

   Future value of $200 per year for 10 years at 8%: $   

   Future value of $100 per year for 5 years at 4%: $   

   Future value of $200 per year for 5 years at 0%: $   

C++

Download the attached program and complete the functions. (Refer to comments)

main.cpp ~

#include 
#include 

#define END_OF_LIST -999

using namespace std;

/*
 * 
 */

int exercise_1() {
    int x = 100; 
    int *ptr; 
    
    // Assign the pointer variable, ptr, to the address of x. Then print out 
    // the 'value' of x and the 'address' of x.    (See Program 10-2) 
    
    return 0; 
}

int exercise_2() {
    int x = 100; 
    int *ptr; 
    
    // Assign ptr to the address of x. Then use indirection to print out the 
    // value of x using pointer variable. (See Program 10-3) 
    
    return 0;
}

int exercise_3() {
    int a[] = {1,2,3,4,5,6,7,8,9};
    int *n; 
    
    // Print the address of the array a, 
    
    // Notice that printing the address of an array is different then printing
    // the address of a variable. 
    
    // Assign the address of the array to the variable n. Then de-reference n 
    // to print out the first, third and fifth elements. (See Programs 10-5 and 
    // 10-6)
 
    return 0;
}

int exercise_4() {

    int a[] = {1,2,3,4,5,6,7,8,9};
    int *n; 
      
    // Assign the address of the array to the variable n. Then use a loop to 
    // print out each element using a while loop (See Program 10-9)
 
    for (int i=0; i<9; i++) {
        cout << "Element " << i << " is " << "... " << endl;
    }
    return 0;
}



int main() {
    exercise_1();
    exercise_2();
    exercise_3();
    exercise_4();
}

1.)Al Attorney is a divorce lawyer. Sam and Mary want him to represent them both in a divorce, as Sam and Mary have worked out all their property division and just need a lawyer to do the paperwork. What should Al tell them?

2.)The personal representative of an intestate estate is called the

3.)Mary owns 10 shares of Acme stock.  At its annual shareholders meeting, there are 5 Directors to be elected. Mary is allowed to vote 50 votes for Director Smith. This is an example of

4.)When Acme Corp. was first chartered, Joe bought 100 of the initial 1000 shares offered. Later, in order to raise more capital, Acme made an offering of 1000 more shares. Joe was offered 100 more shares of the new issue. This is called

Arham has recently joined as a purchase manager at Cripple Technologies Company in Muscat, Sultanate of Oman. He got request from the various departments that they need additional computers. He analyzed all requirements and finally decided to place orders for 100 computers. Cripple Technologies Company has the bidding policy for selecting the best tender, where they take proposals from different computer suppliers. After analyzing all the proposal they finalize the deal. Arham's son (Jasem) works at Fiddley Computer Corporation in Muscat. Arham discussed the requirements with his son and asked him to submit the proposal to his company. Arham received two proposals; one from BMCT Computer Company and another from Fiddley Computer Corporation. Arham hides the BMCT Computer Company proposal in his old cupboards. As a purchase manager, Arham purchased computers directly from Fiddley Computer Corporation as there was no other competitor proposal. Arham purchased 100 computer for about 500 OMR each whereas BMCT Computer Company was selling for around 300 OMR. BMCT Company computers were better than the Fiddley in terms of features and the added benefit of after-sale service for 5 years. Jasem received a good commission on the sale of 100 computers from his company. Arham knew that, if the purchase order had gone through the normal bidding process, Fiddley Computer Corporation would not have been selected. Question 3 i. Do you think Arham did right action by hiding the BMCT Computer Company proposal in his cupboard? Justify your answer with valid reason. [2 Marks - Answer in 50-75 Words] ii. Do you think Arham's action for helping his son by placing the order and helping him in earning commission is correct? Justify your answer with 2 valid reasons. [4 Marks - Answer in 100-125 Words] iii. Is charging a high price for lower value good is right according to the Islamic religion? Justify your answer with reference to the ethical principles in business dealings based on Islamic values. [4 Marks - Answer in 100-125 Words]