The case study describes a series of events that followed an automobile accident. A 46-year-old male was delivered to an emergency department, where he was given 15 milligrams of morphine intravenously to treat for severe pain. The patient died the next morning from an overdose, as he had injected heroin and drank several shots of tequila and multiple cans of beer before the accident. Several years later, the physician was sued for malpractice. The present paper discusses the elements of the negligence claim and possible defences against them.
Elements of Negligence Claim
The estate may sue the physician for failure to screen for drug interaction. According to Collins&Collins (n.d.), screening for possible drug interactions is crucial to avoid preventable side effects of drugs. The physician administered morphine, which is an opioid that may have severe complications in the cases of overdose of interaction with alcohol. Thus, before administering morphine, the physician needs to screen for possible interactions. A history of alcohol or substance abuse can be obtained through the electronic health record (EHR) system (Collins&Collins., n.d.). The details of the claim do not include information on whether the physician tried to access the hospital database before administering morphine; thus, it is unclear if this element of negligence is met.
The estate may also sue the physician for the failure to take an adequate health history. According to the details of the case study, the patient was alert and could answer the questions asked by the physician. The doctor needed to ensure that the patient had not taken any opioids or alcohol to ensure the safe administration of morphine. This could be done by providing the patient with information about all the possible drawbacks of administering morphine and asking the patient if any of the dangerous substances had been administered previously. The details of the claim do not provide information on whether the physician asked if the patient used opioids or alcohol. Therefore, it is also unclear if the element of negligence is met.
Possible Lines of Defense
According to the Academy of Managed Care Pharmacy, care providers are required to provide adequate education about interactions of administered drugs (Collins&Collins, n.d.). At the same time, patients need to be honest about the drugs they are currently using to avoid harmful combinations (Collins&Collins, n.d.). Since the patient was drinking and driving, there is a strong possibility that he concealed the fact that he had administered illicit drugs and alcohol. Another possible line of defense is the mental condition of the patient. Even though the patient was alert, there is a strong possibility that he was unable to understand the education or provide an adequate history of the illness. Thus, the physician decided to treat the pain to be able to talk with the patient and gather the needed information. In other words, the overdose was unpreventable.
Other Possible Claims
I believe that if the death of the patient is a result of subdural hematoma, the estate has the highest chance of success. Considering all the details of the case, the condition developed with moderate speed, and it should have appeared on the CT or MRI scans. Thus, the only reason for death from the condition is the lack of diagnosis or treatment. Considering the fact that head injury is very likely during the car accident, the ED staff should have conducted imaging tests to exclude subdural hematoma. Thus, there is a high probability that death from the condition is a result of negligence.
Collins&Collins. (n.d.). Failure to screen for and monitor drug interactions may constitute medical malpractice. Web.