Guidelines:

I: Identify the Issue R: Identify the Rule: ((e.g., negligence, battery, invasion of privacy, defamation, sexual harassment, breach of warranty, etc.). Please document the language of the rule(s) and its elements. Provide the citation from the source of the rule language. Make sure that none of the facts from the case are included in the rule language. If the rule has more than one element, make sure to include and define each of the elements. Failure to completely define the rule will result in significant deduction of points. A: Apply the rule to the fact pattern C: Conclude with a recommendation to the physician, dentist, or yourself. Make sure to include any case law in your analysis. Write out the holding of the case and then describe how it is similar and informs the recommendation that you are making. Failure to include discussion of the cases will result in significant deduction of points

Scenario # 3: You are a physician practice manager in Charleston, South Carolina. One of your physicians has a patient who was born with maximal hydrocephalus and will not develop cognitive functions beyond those of an infant. The mother of the patient has claimed that one of your physicians was negligent when he failed to detect this congenital defect during a prenatal ultrasound procedure. According to the mother, had she known about the defect, she would have terminated the pregnancy. At the time of the pregnancy, the physician did not possess knowledge or equipment that was capable of curing or at least ameliorating the baby's condition at the time of the failed diagnosis. Based on your knowledge of the law in South Carolina, does the mother have a case for wrongful birth in South Carolina? Please use the I.R.A.C. format when assessing this scenario.

Scenario # 4: In another scenario, you have graduated from Arizona state University and are managing a group practice which includes OB/GYN physicians in Kings Landing. The practice is under severe financial pressure to make a profit and increase its volume of patients. Physicians have been encouraged to see those patients with routine pregnancy cases quickly and to refrain from ordering any unnecessary tests or procedures. You have recently become aware that some of the physicians are not providing their patients with thorough education regarding the risks of a pregnancy after the age of 35. Other physicians are attempting to reduce utilization by refraining from ordering amniocentesis when there are no obvious risks. They may also refrain from informing the parents of its availability and diagnostic purpose. Recently, a patient of one of the OB/GYN delivered a healthy baby girl. However, the baby girl underwent a blood test for Trisomy 21 and was diagnosed with Down's Syndrome. The mother was 42 years of age. During the pregnancy, the first trimester combined test (Blood test and Nuchal translucency test) did not identify any abnormalities. The integrated screening test done during the first and second trimesters of pregnancy also did not indicate any signs of Trisomy 21. However, the parent's attending OB/GYN provided no advice or education was provided to the parents regarding the availability and benefits of Chorionic villus sampling (CVS) or Amniocentesis. 4 The parents are considering their legal options. As a physician practice manager with knowledge of Call v. Kezirian and Berman v. Allan, and Showalter 9th ed., what would your policies be in the following areas: Ordering diagnostic testing during a routine pregnancy, providing information to expectant parent(s), and referring patients for abortions? How would you communicate these policies to the physicians you manage?