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Patient J.W. presented to the emergency department of Community Hospital with a severe headache that had persisted over several days. Nurse Jackie was assigned to

Patient J.W. presented to the emergency department of Community Hospital with a severe headache that had persisted over several days. Nurse Jackie was assigned to care for J.W. The patient was exhibiting a number of signs and symptoms that would have indicated that blood testing and a head CT were warranted. The patient was asked by the triage nurse and Nurse Jackie about any prior neurological issues, persistent headaches, and prior cerebral hematomas. Even though she had a history of all of these things, J.W. was a little disoriented from the pain and denied all past history to both the triage nurse and Nurse Jackie. Nurse Jackie was a graduate nurse three days out of precepting and this was her first solo shift. Jackie charted the symptoms, but did not understand their significance or call the physician. Dr. James, the attending physician, is board certified in family medicine and is a member of the Community Hospital medical staff with emergency department privileges. He has a full-time family practice, and only fills in at the emergency department when the hospital has a critical need. Dr. James worked in an emergency room during his residency but has not practiced emergency medicine full time in the ten years since. Dr. James rounded on J.W. and ordered morphine for the headache and no other tests. Nurse Jackie administered the medication as ordered and documented a reduction in pain. She also noted that the other symptoms did not improve. When Dr. James rounded again, he saw that the pain was reduced and discharged J.W. Approximately four hours later, J.W. was rushed back to the hospital by ambulance and died from a severe brain hemorrhage. 1. What are the important facts of the case? 2. Are all the elements required in a negligence suit present? 3. What standard of care is required? 4. Who would you consider to be the potential plaintiff(s) and defendant(s)? 5. Who would the plaintiff allege was negligent? 6. What evidence would you present against each defendant? 7. What defenses would each defendant raise? 8. What additional information would you like to know?

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