Tort and Negligence in Medicine and Healthcare - Case Study Example

? Tort and Negligence in Medicine and Healthcare Judgments - Bolitho v. and Hackney Health ity ________________________________________ HOUSE OF LORD Lord Browne-Wilkinson Lord Slynn of Hadley Lord Nolan Lord Hoffmann Lord Clyde OPINIONS OF THE LORDS OF APPEAL FOR JUDGMENT IN THE CAUSE BOLITHO (ADMINISTRATRIX OF THE ESTATE OF PATRICK NIGEL BOLITHO) (DECEASED) (A.P.) (APPELLANT) v. CITY AND HACKNEY HEALTH AUTHORITY (RESPONDENTS) ON 13 NOVEMBER 1997 LORD BROWNE-WILKINSON This case relates to the treatment Patrick Nigel Bolitho received in the hands of the health and medical experts at St. Bartholomew's Hospital between January 16-17, 1984 when Patrick was about two years old. Nigel suffered a catastrophic mental/brain damage following a respiratory failure induced cardiac arrest. Patrick was first admitted at the St. Bartholomew Hospital on January 11, 1984 and was diagnosed with croup. The treatment was administered by Dr. Janet Horn, a senior pediatric registrar and Dr. Keri Rodger, a senior house officer pediatrics. The patient was discharged after spending four days in the hospital with no further complaint about the episode and the treatment. The condition of the boy worsened after the discharge and the parents got concerned about his condition following a night of increasing difficulty in the respiratory system characterized by restless, lack of sleeping and breathing difficulty (Steele, 2007). The parent got concerned about Patrick’s condition and sought readmission. The parents therefore took the boy to St. Bartholomew on 16th January. Patrick was examined by the doctors at St. Bartholomew and in particular, Dr. Rodger examined him and got concerned about the worsening condition of the patient. Dr. Rodger made arrangements for Patrick to be attended to by specialized nurse and be given a one-to-one attention. Come the following morning, Patrick’s condition improved and he was further examined and the examination revealed that his condition was better than the previous day. This was evidence by the fact that Patrick even took lunch, something that he was not able to do the previous days. By midday, a series of episodes exploded and the observing nurse summoned a skilled nurse, Sister Sallabank to attend to his awful respiratory sounds, on her part, she bleep Dr. Horn and failed to observe the chain of command in the house after she felt that his condition was very serious and called for an immediate response. At this point, Patrick was very white and had developed a problem with breathing. Even after being informed of the worsening condition of Patrick and the change of color, both Dr. Han and Rodger failed to attend to Patrick immediately. Sister Sallabank went ahead to request for a close attention in to Patrick by informing other nurses to stay close and pay close observation to Patrick. Come in the afternoon, the observing nurse once more called Sister Sallabank to come over as the situation and health condition of Patrick had worsened (Pozgar, 2012). On coming back, Sister Sallabank once more telephoned Dr. Han. Han informed Sister Sallabank that she was out on a regular afternoon clinic and instead she requested Dr. Rodger to attend to the patient. The sister took the initiative to reach out to Rodger and explained to him the episodes in the case of the health condition of Patrick. Dr. Rodger did not bother to attend to the patient even after several attempts and episodes. Instead, she found claimed that the flat batteries of the bleep made it impossible for her to receive any information or message. The events that led to the catastrophe episodes of Patrick begun by 2.30 p.m. when Patrick’s condition drastically changed when he became agitated and started crying. This follows a collapse of the respiratory system that led to a breathing difficulty. Patrick then suffered a serious cardiac arrest. Consequently, he sustained a severe brain damage that led to his final moments on earth, Patrick passed on. The was taken for a trail under Hutchinson J. where the conflict of evidence appeared before Dr. Horn and Sister Sallabank on the content of the two telephone conversations that transpired between 12.40 and 2.00 p.m. judge Hutchinson accepted Sallabank’s version in making the ruling about the verdict. In making the ruling, judge Hutchinson asserted that Dr. Horn breached the responsibility and duty of giving care to the patient even after being informed and reminded Patrick’s worsening condition via telephone. Neither did she make arrangement for a suitable representation in order to rescue the situation. This constitutes negligence on the part of the doctors and the responsible persons. This raises the causation: “…..would the cardiac arrest have been avoided if Dr. Horn or some other suitable deputy had attended as they should have done?” (Steele, 2007). It was a common ground at the end that intubation been provided to Patrick at the right time, then, the respiratory failure that led to the final departure of Mr. Patrick would have not occurred or the it would have been possible to minimize the effects of the cardiac failure. The judge did identify the questions relating to tort and negligence in this case. Horn in her defense explained that her coming to attend to Patrick by 2.00 p.m. would not have given her enough time to arrange for intubation, a position that the judge accepted (Best & Barnes, 2007). However, the judge hinted that Dr. Horn would even have arranged for speedy intubation, a position that looked very irrelevant since Patrick’s health had deteriorated and any intubation or similar arrangement would not have made any difference. This provided the answer to the first question raised by the judge. Referring to the second question (whether a competent doctor would have done the intubation), the judge collected evidences from eight medical experts, of which five represented Patrick who were for the idea that even after the second episode, the intubation would have been done by any competent doctor. Dr. Heaf was the most impressive party to the judge out of the five. The defendants on their part sought for the services of three medical experts. The defendants team on their side argued that by studying the symptoms and signs presented by Patrick (recounted by nurse Newbold and Sallabank) intubation would never be effective or appropriate. In the view of the judge, the most impressive among the defendant’s team of experts was Dr. Dinwiddie. The plaintiff’s experts founded their premises on the fact that “…… over the last two hours before the catastrophe Patrick was in a state of respiratory distress progressing inexorably to hypoxia and respiratory failure” (Best, & Barnes, 2007). The judge ruled that the recounted position on the health condition of Patrick as reported by the two doctors was inconsistent. The judge held that different views of Dr. Dinwiddie and Heaf, although very contradicting, both cases represented a responsibility on the part of health professionals. Therefore, the judge held that it would have been very professional and competence had Dr. Horn attended to Patrick and not intubated (as per the professional standards of duty presented by Dr. Dinwiddie). The judge therefore ruled that there was no sufficient proof to show that the defendant’s breach of duty was the cause of the catastrophe that befell Patrick, neither was sufficient evidence to constitute negligence or torturous event in this case. References Best, A., & Barnes, D. W. (2007). Basic tort law: Cases, statutes, and problems. Austin: Wolters Kluwer Law & Business. Hendrick, J. (2000). Law and ethics in nursing and health care. Cheltenham: Stanley Thornes. Pozgar, G. D. (2012). Legal and ethical issues for health professionals. Sudbury: Jones & Bartlett Learning. Steele, J. (2007). Tort law: Text, cases, and materials. Oxford: Oxford University Press. Read More