Legal aspect of healthcare
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Please review the following questions and let me know if you can guide me in answering them (Each response minimum 300 words APA format).
1) Describe the early hospitals of the United States. How did these facilities compare in design and role with the hospitals of the US today?
2) Discuss the various forms, degrees, and elements of negligence under US law. Provide a specific example of how the elements of negligence apply to negligence in the delivery of healthcare services.
3) List and explain the primary sources of law in our U.S. legal system. For each source of law, relate the source specifically to healthcare law and provide examples of relevant applications. Connect each source of law with your own current healthcare organization, or one which you hope to lead.
4) Summarize current anti-trust and restraint of trade laws which have a direct impact on our practices as healthcare administrators. How is our decision-making, as healthcare leaders, impacted by these laws?
5) How are crimes distinguished from civil wrongs? List and briefly discuss three of the six listed elements of criminal procedure and discuss at least one illustrative case example related to healthcare to illustrate these concepts.
6) What is meant by contract "performance" in healthcare settings? What are the nonperformance defenses which apply under healthcare law?
7) Review the case law example, Caruso v. Pine Manor Nursing Center (Attached)
How does the element of foreseeability apply to this case, and what is the key lesson which can be learned by healthcare facilities from this case law example? at least 500 words in length response (APA format)
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Citation: Caruso v. Pine Manor Nursing Ctr., 538 N.E.2d 722 (II. App. Ct. 1989)
Facts
In Illinois, a nursing facility by statute ha s duty to provide its residents with proper nutrition. Under the nursing Home Care Reform Act, the owner and licensee of a nursing home are liable to a resident for any intentional or negligent act or omission of their agents or employees that injuries a resident. The act defines neglect as a failure of a facility to provide adequate medical or personal care or maintenance, when failure results in physical and mental injury to a resident or in the deterioration of the resident's condition. Personal care and maintenance include providing food, water, and assistance with meals necessary to sustain a healthy life.
The nursing facility in this case maintained no records of the resident's fluid intake and output. A nurse testified that such a record was a required nursing facility procedure that should have been followed for a person in the resident's condition, but was not
The resident's condition deteriorated after staying 6.5 days at the facility. Upon leaving the facility and entering a hospital emergency department, the resident was diagnosed by the treating physician as suffering from severe dehydration caused by an inadequate intake of fluids. The nursing facility offered no alternative explanation for the resident's dehydration condition
The trial court found that the record supported a finding that the resident had suffered from dehydration as a result of the nursing facility's negligence. The defendant appealed the jury verdict.
Issue
Did the nursing facility resident suffer harm as a result of the facility's negligence?
Holding
The IIIinois Appellate Court upheld the trial court's finding that the resident suffered dehydration due to the nursing facility's negligence.
Reason
The evidence demonstrated that the proximate cause of the resident's dehydration was the nursing facility's failure to administer proper nourishment; therefore, the jury reasonably concluded that the nursing facility's negligence caused the dehydration.
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Solution Summary
The legal aspects of healthcare are determined. The primary sources of law in our United States legal system is determined.
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Legal aspect of healthcare
1) Describe the early hospitals of the United States. How did these facilities compare in design and role with the hospitals of the US today?
The first known hospital in the U.S. dates back to 1663 on Manhattan Island where a hospital was established to care for wounded soldiers. However, it was some 50 years later that Philadelphia became the hub for hospital advancements and ingenuity. The first hospital in Philadelphia was based on ideals from Dr. Thomas Bond and his vision of a central location for physicians to help the sick. Dr. Bond, along with many other prominent Doctors and Engineers of the time helped make the ideal a reality by forming the Pennsylvania Hospital which Benjamin Franklin helped Bond design in 1755. This first official hospital in the U.S. that Franklin designed had a modern approach with two wings branching off a central administration area (Pozgar, ch.1, pg.5).
Although the need for hospitals was acknowledged and many cities began to build these structures over the next several years, there were as many mistakes being made as there were advancements in medical care. The early hospitals in the U.S. often had limited space and supplies, had no standards for sanitary conditions or safety, did not understand bacteria and disease control, and often hurt their patients more then they helped them. These frightful conditions were brought to light by Dr. John Jones in a book he researched and published in 1775 (Pozgar, ch.1, pg. 5-6).
From a design and role comparison, the hospitals of the 18th and 19th century had the same similar design, multi bed facilities in the community that had the capacity to treat numerous types of conditions. The role was also very similar to the role of hospitals today in that their mission was to bring together a collection of talented physicians in one place who could work together and treat the sick and dying of their communities (Pozgar, ch. 1, pg. 5-7). Although much more complex and vast, the overall principle of today's hospitals design and role in society is the same as the original founders ideals over 200 years ago.
2) Discuss the various forms, degrees, and elements of negligence under US law. Provide a specific example of how the elements of negligence apply to negligence in the delivery of healthcare services.
The three forms of negligence that Pozgar discusses in chapter 3, page 33 of his text is:
1- Malfeasance - Performance of an unlawful or improper act.
2- Misfeasance - The improper / mistaking performance of an act that results in injury or death
3- Nonfeasance - Failing to act when there is a duty to act under conditions that dictate you should
When applying negligence in tort law, the two degrees that are considered in court are ordinary negligence and gross negligence (Pozgar, ch.3, pg.33). Ordinary negligence in medicine is a healthcare provider's failure to do or not do what a prudent person would in a similar situation. Gross negligence is the willful and wanton omission of care that would be proper or choosing to conduct any other acts that are improper.
Legally, there must be four specific elements present in a plaintiff's case if they hope to successfully recover damages they incurred. The four main elements that are considered by courts are, Duty to Care, Breach of Care, Injury, and Causation (Pozgar, ch.3, pg. 33).
The elements of negligence and how they apply in court are clearly displayed in Figure 3-1 (the four elements of an act of negligence) in chapter 3, pg. 34. It is important to note that in order for a plaintiff to obtain a favorable ruling, they must show evidence of all 4 elements existed in their case and their evidence must outweigh the evidence of the defendant's evidence in order to be successful. This standard of showing evidence is not as demanding on a plaintiff as would be the standard of beyond a reasonable doubt that is required in a murder trial. As long as the plaintiff can show some form of negligence occurred and apply the 4 elements, they have a decent case for receiving compensatory damages (Pozgar, ch.3, 34).
A good example of the elements of negligence being applied in a lawsuit can be found in the case of O'Neill v. Montefiore Hospital in ch. 3, pg. 34. The plaintiff in this case demonstrated that all four elements of negligence were present. Duty to care existed because it was an emergency room. Breach of care occurred because the Dr. and Nurses refused treatment to the patient based on insurance issues. As to the injury element, this case resulted in the death of the patient upon being sent back home as they were in fact having a heart attack that went untreated. This refusal to treat a patient immediately who was having chest pains in the ER was a departure from the norm which substantiated the causation element. So, in this case, ...
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