Application: Legal and Ethical Issues of a Medical Error Case Health care providers are fallible and will make mistakes. Unfortunately, these errors can sometimes have dire consequences for patients, and the providers, as well as the organizations, may be held liable for the harm that resulted. In this Application Assignment, you will analyze a case study of medical error for its legal and ethical implications, and propose ways that a health care administrator might help prevent this kind of error from happening. Review the scenarios of medical errors in the following readings from this week and select one of them to focus on in the paper. 1. Gallagher, T. H. (2009). A 62-year-old woman with skin cancer who experienced wrong-site surgery: Review of medical error. JAMA: Journal of the American Medical Association, 302(5), 660-5 77. 2. Part 1, "Understanding the Causes and Costs of Medication Errors," pp. 43-45 (Case on the death of the day-old infant), Preventing Medication Errors: Quality Chasm Series (2007), http://books.nap.edu/openbook.php?record_id=11623&page=43. 3. Rosenthal, K. (2004). "Where did this patient's I.V. therapy go awry?" Nursing, 34(5), 56-57. Prepare for the paper by considering the following: What laws were, or may have been, broken in this case, and by whom? Did you agree with the assessment of liability (if any) provided in the scenario? Why or why not? What are the main ethical issues of this case? Health care providers are sometimes reluctant to admit wrongdoing, provide full disclosure, or apologize to the victim or family, or they are advised not to by legal counsel, risk managers, or others. Reflect on the discussion in the JAMA article about disclosing errors to patients and families. What are some of the legal and ethical implications of disclosing errors in your selected case? What lessons could a health care administrator take from this case? Consider the role of the administrator in establishing and monitoring policies and setting the tone for the organization. Are there ways in which an administrator might help to prevent these kinds of errors from happening? The Application Assignment: With these thoughts in mind, write a 3- to 4-page paper in which you address the following questions: Summarize the legal aspects of this case. Identify the laws that were, or may have been, broken. Who was, or may have been, liable? Did the provider fail in any way to adhere to ethical standards? How might this have impacted the patient outcome? If noted in the scenario, how did the provider interact with the patient or family after the error came to light? Discuss the pros and cons of having the provider disclose and apologize for the error to the patient or family soon after the occurrence. What are the legal and ethical implications of this approach? In general, how might this approach impact the physicians, nurses, technicians, or others who may have contributed to a medical error that harmed a patient? In what ways can health care administrators help prevent the kind of error described in the scenario from happening in the first place? How can they assist the providers and organization after such an error occurs? This 3- to 4-page paper is due by Day 7 of Week 3. See the Week 3 Application area for submission instructions. Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from this week's Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your intext citations and reference list are correct. Application: Organizational Responsibilities and a Troubled Physician The obligations between health care providers and the organizations for whom they work run in both directions, and these obligations are both legal and ethical. In the Application Assignment, you will consider a scenario involving a troubled physician and discuss organizational liability issues arising from this individual's behavior. You will also propose ethically appropriate measures an organization can and should take on this physician's behalf. To prepare for the Application: Read the following scenario, imagining that you are an entry-level administrator at this hospital who is being asked to give advice to the CEO about this case. Consider the rights and duties that are entailed by this kind of contract. Consider, too, not only the legal liabilities and obligations of the organization in this scenario, but also assess what you think are the organization's ethical duties to this physician. Dr. Smith is an experienced, talented, and high-admitting cardiac surgeon. Currently, he is a communitybased physician with privileges at the hospital. The hospital board would like to ask Dr. Smith to become a partner in their venture of creating a cardiovascular institute. The board sees this as an important step in expanding the hospital's market share and revenues. Dr. Smith is in the midst of a bad divorce and has been seen on several occasions by hospital employees in a state of inebriation in restaurants around town. On one occasion, he was reported by a nurse to be inebriated the night before he was scheduled to perform surgery at 7 a.m. The nurse who saw him reported this to her supervisor. In this particular instance, Dr. Smith did not perform the surgery, calling in sick instead. Based on these reports, however, hospital administrators and staff members are concerned that he might perform surgery at a later date in an impaired state. In addition, Dr. Smith made technical errors during a couple of recent surgeries, although there is no evidence that the mistakes resulted from the after-effects of drinking. The Application Assignment: Describe the advice you would give to the CEO by addressing the following questions in a 3- to 4-page paper: Legal Aspects What are the main liability issues in this situation? Under what circumstances might the hospital itself face liability? What is the hospital's authority in this situation, and to whom do they have responsibilities? What difference, if any, would it make if the physician were an employee instead of a contractor? How would matters change if the physician became a partner in the cardiovascular institute? As the administrator giving advice to the CEO, what further information would you need to know to proceed in this situation? Is the medical staff process relevant to dealing with this situation, and if so, how would it be included? Who would be involved in that process? What would the possible outcomes be? Ethical Aspects Discuss the ethical issues that arise from this situation, focusing in particular on the providers involved (e.g., Dr. Smith and the other health care staff). What do you think is the organization's ethical responsibility in this situation? Explain your reasoning. What resources could you, as an administrator, draw on to help you assess the ethics of this situation and determine the most appropriate steps to take? Synthesis In light of your analysis of the legal and ethical issues involved in this case, what advice would you give the CEO? How would you as an administrator prepare for and prevent this kind of problem? This 3- to 4-page Application Assignment is due by Day 7 of this week. Your written assignments must follow APA guidelines. Be sure to support your work with specific citations from this week's Learning Resources and additional scholarly sources as appropriate. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct