The Board received a complaint on 04/02/2014 regarding patient Gloria Kinder from Dena Andrews who has a POA for health care matters on the patient. The complaint was regarding Dr. Negron taking over care of the patient after her primary care doctor retired. The complainant states that the doctor would not refill her potassium, did not do follow up labs, and would not care for the patient.
I interviewed the complainant via telephone as I had made several attempts to contact her for interview but was unsuccessful. On 02/02/2015 Ms Dena Andrews was contacted and she advised that the patient was incarcerated in Vandalia at the women’s prison for theft and has been there since October 2014. Andrews stated that the main problem with the doctor was that he would not write prescriptions for potassium for the
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Negron was the original prescriber of the potassium and she told me that Dr. Valtos was her cardiologist and wrote the original prescription.
Dr. Negron had been contacted on 12/08/2014 after I located him in Washington, Missouri at Mercy Hospital. He had relocated there in November 2014 and is a hospitalist and works 7p.m. to 7a.m. Med Staff had reviewed the complaint and had no questions for the doctor as he had sent the Board a letter dated 06/03/2014 which followed her care from 06/05/2013 to 03/11/2014 which was the last time the doctor saw her. The start date was verified in the medial records as Dr. Negron showed he first saw her on June 5, 2014 in his letter.
Dr. Negron stated that Dr. Valtos was her cardiologist and was maintain her potassium and that Negron would fill it for her sometimes when she ran out. He stated that the practice has a 48 hour refill policy which he sent to the Board and that frequently the patient would run out, go to the pharmacy and call the office to have it refilled immediately. He advised her frequently of the policy and even refilled it for her sometimes, but she would not adhere to the
In July of 2010 in Miami, Florida, Richard Smith, a 79-year-old dialysis patient was admitted to the ICU after a dialysis appointment left him with severe shortness of breath. The following day after being admitted the patient complained of an upset and the doctor had prescribed him an antacid. Uvo Ologboride, the nurse taking care of Mr. Smith, gave him a deadly dose of a drug called pancuronium, which is a drug that induces paralysis, instead of the antacid. 30 minutes later the patient was found unresponsive, but they were able to revive him. Unfortunately when he was revived, he was left brain dead to which did not settle well with his family. When the patient son had came in he had found his father unconscious, unresponsive, and on a respirator. When looking over the chart to try and figure out what happened it had said his dad had just been resuscitated 10 minutes earlier and the nurse had pretty much told him to go and speak with the doctor. Upon speaking to the doctor he was told the nurse had given his dad the wrong medication which lead to his current state of his condition. The nurse was not able to be reached and spoken to about what happened on that fatal day but from what the doctor had explained was the nurse had grabbed a
Ohio Dep’t of Rehabilitation & Correction are the poor-quality patient care that Tomcik received and Tomcik’s health being at risk. Once engaged in a doctor-patient relationship, physicians are obligated to provide the best possible care for the patient by utilizing their skills and knowledge as expected from a competent physician under the same or similar conditions (“What Is a Doctor’s Duty of Care?” n.d.). However, in Tomcik’s situation, Dr. Evans did not deliver high-quality care, for he administered a perfunctory breast examination and thus did not follow standard protocols. There is evidence of indifference conveyed by Dr. Evans, and the lack of proper care towards Tomcik is an issue that can be scrutinized and judged appropriately. Additionally, Tomcik’s health was at risk due to the failure of a proper physical evaluation and the incredibly long delay in diagnosis and treatment. The negligence from Dr. Evans, along with the lack of medical attention sought out by Tomcik after she had first discovered the lump in her breast, may contribute to Tomcik’s life being in danger as well as the emotional anguish she may have felt during that time period. Overall, the incident of Tomcik’s expectations from the original physician and other employees at the institution not being met is an ethical issue that should be dealt with
The staff believed the patient’s altered behavior was due to the possible drug withdrawals. While the symptoms are similar, there are distinct differences between hypovolemic shock- secondary to blood loss, and acute opiate withdrawals. With a thorough exam, the staff should have been able to recognize this difference. The Clinical Opiate Withdrawal Scale, (Wesson, D. R., & Ling, W., 2003) would have been the proper objective measurement tool to be able accurately, assess the patient. Another breach of duty was not getting the CT scan down in an appropriate amount of time. The physician had a high index of suspicion that the patient was bleeding internally, yet the CT was not completed until the following morning. Lastly, the patient admitted to a substance abuse problem, yet a drug screen was not ordered. If it had been, they would have seen there were no opiates in his system and he was positive for alcohol and benzodiazepines.
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This writer explained to the Yommala that the patient returned to the clinic with no paper works and it appears to confusion as to whether or not this patient was scheduled to do a medical procedure or seeking inpatient treatment. According to Yommala, she has been updating ROUNDS about this patient and the patient medical procedure was scheduled in advance in the hopes that the patient would be negative from all illicit drugs to
My patient was assigned to Ms. Capace under the management of Roberta Costanzo RN NP. Since becoming involved in my patient’s care, Alicia has gone above and beyond to communicate with the patient, myself and my office, the patient’s insurance company, the ER and hospital staff, outpatient treatment
Additionally, he should have refrained from saying that Mark and Al Roker are the same and are both chubby. This would have projected a benevolent image of Jerry and make him more likeable.
I have been a patient of the OBGYN side of Lone Star Circle of Care for years but just recently my primary care doctor stopped taking my insurance. So I made a new patient appointment with the Ben White location in Austin, Texas with Dr. Rivera for the 17th of February. I checked in on the 17th and sat down to wait. Thirty minutes went by and I asked the front desk if they knew how far behind Dr. Rivera was. The front desk did not seem interested in this question but did ask a person that came from the back how far behind Dr. Rivera would be. I didn’t get an answer but the front desk at that time did write in on the “Doctor running late” board that she was running thirty minutes behind. I sat down and waited, after another 12 minutes I asked for an
The patient is a female in her early twenties who came in the hospital due to sickle cell crisis. She was in grave pain especially in the joints. Her hemoglobin level was low so the Physician ordered 2 bags of packed red blood cells and pain meds Q4hrs. The patient explained many times that the dose the physician ordered was not sufficient and that she needed more help. The nurse promised to contact the physician and to inform her of the response. The fact is she never did and was called urgently hours after to calm her patient who was crying in agony and wanted to go home to be in pain. She screamed out that no one cared. Some nurses were even callus enough to say if she wanted to leave then hand her the relevant document and allow her to go.
One important fact in this case is medication that the physician administered to the patient is not listed in the case study. All information must be documented, this helps to keep track in the event the patient gets a reaction this is significant information that must be recorded. Although this may be unimportant to the case this should still be listed. As this patient condition worsened he was diagnosed with osteomyelitis. As mentioned above knowing all medications being administered are important, when treatment first began the pharmacist in this case did exceptionally well keeping track of the medications being administered. Another important factor is that the pharmacist kept track of the care being provided to the patient because the pharmacist reviewed patient results he was able to make suggestions to the physician to check the patients creatinine levels. However the pharmacist in the case is the defendant. Although the pharmacist did well in reviewing the patient’s information during most of the treatment, he did fail to do a follow up check. The
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house.
In conclusion, any medical practitioners going professional should be competent, having main obligation of the health of their patients being first priority. They should act in integrity abiding to the set laws protecting the rights of the patients. The outlined WAC 388-805-305 patients’ rights and RCW 49.60.030 civil rights, guides the practitioners to make sure they provide the best care and treatment to support them to live as well as possible.
There were many ethical issues within this case; the first indication of an ethical problem was the administration of an incorrect medication to the patient. The doctor, administration, and providers involved in the care of the patient must decide what is ethically moral when informing the patient. I believe that it is the patient’s right to know that she received the wrong medication for a number of days. Although no major medical consequences occurred, I believe this
Explain the teaching role and responsibilities in education and training, including how this relates to the teaching/training cycle.
The nurse confirmed patient identification, asked subjective questions focusing on chief complaints, performed a focused assessment, obtained medication list, baseline vitals, and assessed the patient’s past medical history. She asked the patient questions such as previous hospitalization/surgery, metal implants, allergies, health history, sleep apnea, and alcohol/tobacco use. The nurse told the patient the doctor would be with her shortly. The nurse reported to the doctor regarding the patient and obtained orders for treatment from the doctor. The nurse then started an IV line and hung an IV solution bag of normal saline because the patient was experiencing abdominal pain. The nurse also administered pain medications and the patient was ready to be discharged. The nurse gave discharge instructions and made sure that the patient had a ride