Scenario Two:

Scenario Two:

Myrna Matthews went on her own to the Emergency Department of Midwest Hospital on August 10th. She complained of burning pain in her upper chest that had radiated down her right arm that evening as well at the previous evening. When she arrived at the Emergency Department at 11:25 PM, she was triaged by a nurse who took her vital signs, recorded her medical history, and made an assessment of her immediate medical needs. Although slightly elevated, Matthews' vital signs were within normal limits. The triage nurse classified Matthews as a ""category two"" patient, a non-threatening condition. She was told that she would have a long wait, as the emergency department was very busy.  A social services representative spoke to Matthews between six to eight times during her wait. He felt she was in no apparent distress during those times that he had spoken to her. Following the 4-� hour wait, Myrna decided to leave without being treated. At this time, the social services representative told Ms. Matthews that a treatment room was ready for her and that she would be seen shortly. Mathews said that she had already waited long enough, and she was leaving. She said she would see her own doctor in the morning. Ms Mathews signed a release for leaving against medical advice (AMA). Mathews went to work the following day without seeing her own doctor. She died two days later from a heart attack.

 Identify who may be negligent?

What duty did the party owe to the patient? The duty should be specific to this situation. Duty to provide good or competent care is not specific.

What was the breach of duty? This too should be specific to the situation.

What was the injury or harm?

Did the breach of duty cause the injury?

Are the essential elements of negligence/medical malpractice present? If they are not present, identify which of the elements are missing."

1. Find Out the Parties to the Contract Whom the Court May Treat as being at Their Negligent Best

 The following parties may potentially be negligent:The potential negligent parties include the following.

 The Triage Nurse: Responsible for making a decision on patients and which order they should be attended to in a certain facility.

 The Social Services Representative: Monitoring patient’s affect and psychological condition, and ensuring they pay proper attention as and when they should.

 2. On the basis of legal and ethical premises that stipulate the correct route outcome of professional practice, patient autonomy is the professional responsibility towards patient.

 Triage Nurse:

 Statutory requirement to assess the likely outcome for the patient and the state of any of their conditions in order of priority. Concerning the symptoms that Myrna and she is suffering from, the described burning chest pain that radiates to arm points possibly to myocardial infarction. Apparently, the role of the nurse was to label these signs as danger signs and respond adequately.

 Social Services Representative:

 The responsibility of checking up on the patients from time to time and inform them of their status and how long it will take to be attended to and where necessary extend a hand. Clinically, they should have had some alarm features of interventions or, worse, Myrna’s health deteriorating further.

 3. Breach of Duty

 Triage Nurse:

 The breach was made if the nurse had not appropriately evaluate Myrna to be fit within higher than category two of symptoms. By standard application of the conventional triage procedures severe chest pain with radiation to the arm could be suggestive of an emergency condition.

 Social Services Representative:

 What I think never happens is if the representative does not track myrna condition over time and poorly transmit her symptom indicators to the medical personnel. Plus they should also have ensured that Myrna was taken for medical attention; if they did not or if they did not do it as they should then it would qualify to be a breach.

 4. Injury or Harm

 Myrna Matthews had a heart attack two days after she fainted in the pilot’s seat. But the injury that befell her is death by myocardial infarction; a condition that could have been prevented if tended to early enough.

 5. Was the Injury of a Kind that the Breach of Duty Entails?

 To determine causation:

 Triage Nurse: If Myrna’s condition was not treated well and if appropriate care was not given to her then it may be the fact that she could not receive the appropriate and necessary critical care which might have over complicated her ailment.

 Social Services Representative: This delay could be attributed to if the representative failed to record that the symptoms of the patient worsened or if he failed to assure the patient get a proper attention from the medical team.

 6. Aspects of Negligence/Medical Malpractice that Nobody Can Dispute

 The essential elements of negligence include:Negligence elements are as follows:

 Duty of Care: The triage nurse and social services worker also had responsibilities of the care of Myrna.

 Breach of Duty: This duty might have been breached if, for instance, the triage nurse at some point assigned Myrna’s condition wrongly or if the social services representative did not observe signs of distress or ensure that Myrna get the necessary attention in the right time.

 Injury: Myrna about aactic entailment, had a heart attack and death.

 Causation: How Myrna died as the consequence of the breach of the duty must be made very clear.

 Summary

 Based on the information provided:In light of the information which you have given:

 Potential Negligent Parties: The triage nurse’s goal and the social worker.

 Duty of Care: To determine and analyze a patient state and schedule the necessary treatment (the triage nurse); for monitoring a constant state of a patient and for providing his/her treatment at the proper time (the social services representative).

 Breach of Duty: Risk management: incorrect assessment of the severity of the case; inactivity in response to distress and lack of care provisions from the social services representative.

 Injury: Primary site being the heart with the principal cause of death being myocardial infarction.

 Causation: This could have possibly been caused by a delayed treatment by the defendant, breaches of duty which would have been fatal to a Myrna.