N PARTICULAR, CONSIDER WHAT CLAIMS THE WOMAN'S ESTATE MIGHT HAVE AGAINST THE VARIOUS PARTIES INVOLVED; WHAT THE LEGAL ISSUES MIGHT BE; IDENTIFY THE STANDARDS THAT WOULD BE APPLIED IN EVALUATING THE PARTIES' CONDUCT; AND CONSIDER WHAT ADDITIONAL FACTS MIGHT BE IMPORTANT.

A woman had been suffering with digestive unrest.She felt pain in her abdomen and had sought to obtain an x-ray at a freestanding imaging center, but her insurer denied coverage for an exam not authorized by her primary care physician.Later that day she appeared at the emergency room of a Connecticut hospital.She was experiencing severe abdominal pain.A physician on staff asked her if she was pregnant.She said that she was not.The physician asked her questions about her health history and recent eating habits.She could not answer these since she had only a very limited English vocabulary, being a native Spanish speaker.The doctor then grew frustrated and asked if she could come back to see him in his private office in the morning, handing her his office card and telling her to come to his office at nine in his limited Spanish.The woman nodded and left.

She returned the next day with a very high fever.The physician's partner who spoke Spanish examined the woman.He determined that she had a severe bowel blockage.He told her in Spanish that he needed to perform a surgical procedure at the local hospital and that there was no time to wait.The physician's office contacted her insurer, who suggested that the woman instead have surgery at an in-network facility somewhat further away.The woman became frustrated, and left the office without discussing the matter further.

Later that day, she reappeared.The office staff rushed her to the emergency room. The Spanish-speaking physician performed the surgery, but allowed a physician's assistant employed by the hospital to close the wound, as was standard practice at the hospital.The woman came out of surgery, but quickly lost consciousness.She was raced back into surgery where extensive bleeding was revealed due to a punctured bowel, and a surgical sponge that had not been removed was discovered.The woman died during this second surgery.