Medical Malpractice and Risk Management

Assignment 3: Medical Malpractice and Risk Management

Case scenario:

A 37-year-old woman with a past medical history of chronic pain related to chronic sinusitis and multiple sinus surgeries, anxiety, panic attacks, sleep disturbance, depression, and opioid abuse is the case under review.  Her chronic pain has been most recently managed by her ENT and infectious disease specialists respectively due to the retirement of her chronic pain manager.  The ENT and infectious disease specialists have determined to refer the patient back to her primary PA for further pain management as they had both been independently advised by her insurance provider that there was evidence of irregular and excessive prescriptions signaling potential opioid and methadone abuse.  The referring physicians neither shared the warning letters they received nor advised the PA in any way of the narcotic abuse concerns.

The day the patient followed up with the PA concerning her chronic pain issues, the PA obtained and documented a thorough list of the patient’s prescription use as well as past and current medical history.  A urinalysis was obtained to determine the patient’s level of methadone use and was found to be appropriate for the patient’s height and weight.  The PA did not observe any other “red flags” which would have required further investigation.

The PA subsequently determined that the patient would be prescribed a sufficient quantity of methadone to last for the next 28 days.  The patient was also instructed and, was compliant with, and acknowledgement of narcotics and medication regimen compliance agreement.

The patient was found dead 15 days later after her consultation with the PA.  The findings of the subsequent autopsy revealed the cause of death to be methadone toxicity.

Assignment:

For this case please discuss, in detail, the various issues of risk inherent in this scenario.  Particularly, how each participant may have added to the risk through the handling of their part of the case and/or failure to communicate.  What are the lessons that can be learned from this case?  Does the responsibility for the outcome lie solely with the providers or is there some responsibility shared by the patient?  In the case of a monetary settlement, whom should benefit from this?  Should one single entity be held responsible for all the liability or should there be an equitable share of responsibility?

The paper will contain 3-3.5 of text, double-spaced, and 12-point Times New Roman font with one-inch margins. Please cite 4 references. APA format must be used throughout including title page and reference page. In addition to this paper, two learning outcomes will be chosen and document how each learning outcome was met in a reflection-style paragraph. The learning outcome reflections should be included on a separate page after the APA reference page.

Learning outcome 1: Understand the components of patient advocacy

Learning outcome 2: Apply an understanding of the mind-body connection with spirituality and how it affects disease, healing, palliative and end-of-life care