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Similaire à Here are my thoughts on the case:- The basis of the case would be medical malpractice due to failure to properly diagnose and treat the cervical spine injury. - The blame lies with the ER staff for failing to properly immobilize and image the cervical spine initially, missing the injury. - The patient deserves compensation for the additional injury (paralysis) caused by the missed diagnosis and improper handling after the initial x-rays.- The patient would be the plaintiff suing the radiographer/facility for malpractice. - The radiographer held responsibility to properly image and document the cervical spine given the mechanism of injury described. - Proper immobilization and adequate imaging of the entire cervical spine initially
Similaire à Here are my thoughts on the case:- The basis of the case would be medical malpractice due to failure to properly diagnose and treat the cervical spine injury. - The blame lies with the ER staff for failing to properly immobilize and image the cervical spine initially, missing the injury. - The patient deserves compensation for the additional injury (paralysis) caused by the missed diagnosis and improper handling after the initial x-rays.- The patient would be the plaintiff suing the radiographer/facility for malpractice. - The radiographer held responsibility to properly image and document the cervical spine given the mechanism of injury described. - Proper immobilization and adequate imaging of the entire cervical spine initially (19)
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Here are my thoughts on the case:- The basis of the case would be medical malpractice due to failure to properly diagnose and treat the cervical spine injury. - The blame lies with the ER staff for failing to properly immobilize and image the cervical spine initially, missing the injury. - The patient deserves compensation for the additional injury (paralysis) caused by the missed diagnosis and improper handling after the initial x-rays.- The patient would be the plaintiff suing the radiographer/facility for malpractice. - The radiographer held responsibility to properly image and document the cervical spine given the mechanism of injury described. - Proper immobilization and adequate imaging of the entire cervical spine initially
- 1. RAD 2321 Basic Patient Care LEGAL ISSUES FOR RADIOGRAPHERS Lesson 1 A Case Study… University of Arkansas for Medical Sciences Division of Radiologic Imaging Sciences
- 2. At the completion of this course, the student will be able to: ◦ Explain legal terms, principles, doctrines and laws specific to the radiologic sciences according to the American Registry of Radiologic Technologists ◦ Outline the conditions necessary for a valid malpractice claim. ◦ Describe institutional and professional liability protection typically available to the radiographer according to the American Registry of Radiologic Technologists
- 3. You will need to read the following sections in your Patient Care textbook ◦ Chapter 2, pages 50-51 on Professionalism 52-54 on Practice Standards 58-63 on Ethical Judgments and Conflicts 65-71 on Legal Considerations ◦ Appendix A, pages 382-394 on Radiography Practice Standards You will also need to read the “Standards of Ethics” section on the ARRT website found at www.ARRT.org
- 4. It’s early morning on a rural road in southern Arkansas. Two vehicles collide. One driver is unharmed, the other is penned in his vehicle for half an hour until a rescue unit can extract him. ww.swtimes.com/PhotoGallery/Galleries/Kaia/15.html
- 6. When he got to the ER, the physician was with another patient. The charge nurse ordered his x- rays. I am sure that you know when a patient complains of neck pain following an accident, it’s a good idea to take a radiographic look at the spine for possible fracture. A fractured vertebra that is undiagnosed has the potential for causing damage to the spinal cord. X-RAY!
- 7. Lateral cervical spine http://www.emergencycare.co.nz/courses/default.asp Immobilization in place Weist P., Roth P. Fundamentals of Emergency Radiology 1996
- 8. C5??? C1 C6??? C2 C3 C7??? C4 Weist P., Roth P. Fundamentals of Emergency Radiology 1996
- 11. Sagittal section MRI Weist P., Roth P. Fundamentals of Emergency Radiology 1996
- 12. The area not visualized on the first lateral projection had major damage – it just couldn’t be seen. When the cervical collar was removed, the neck was no longer stabilized. The unstable spine changed position as the patient moved, damaged the spinal cord at the site of injury, and a major paralytic event occurred. On the previous slide you can see a typical lower cervical spine injury – one vertebra displaced over another, called subluxation.
- 13. Look at the facts of the case and form an opinion based on the reading assignment in your text and on the ARRT website. Yes No
- 14. What would be the basis of the case? Where would you place the blame for the patient’s injury? What justification or compensation do you feel the patient deserves? Is the patient the plaintiff or defendant?
- 15. What responsibility does the radiographer hold? What could have been done differently to prevent this injury? Do you feel the patient is owed any compensation? Is the radiographer/facility the plaintiff or defendant?
Notes de l'éditeur
- This portion of Basic Patient Care discusses legal issues that are pertinent to the profession of radiologic technology. Lesson one is a case study. At the end of the lesson you will be asked to give an opinion about the case and submit your thoughts to course faculty via the Submit Assignments tool in the Library. You will have a deadline to meet for the assignment – you will find it on the Calendar.
- It’s early morning on a rural road in southern Arkansas. Two vehicles collide. One driver is unharmed, the other is penned in his vehicle for half an hour until a rescue unit can extract him.
- After being extracted from his vehicle, the man was taken by ambulance to a local hospital. He had several minor injuries, but his major complaint was neck pain.
- When he got to the ER, the physician was with another patient. The charge nurse ordered his x-rays. It is not uncommon for nurses to order radiographs in the emergency room when a physician is not immediately at hand. And I am sure that you know when a patient complains of neck pain following an accident, it’s a good idea to take a radiographic look at the spine for possible fracture. A fractured vertebra that is undiagnosed has the potential for causing damage to the spinal cord.
- When the spine has been injured, in this case the cervical spine, the immobilization device that was put in position at the the crash site is left on the patient until the first radiographs are made. The picture on the left shows the patient lying on a spinal board, with both the head and the neck firmly immobilized. The first image made is a side view of the spine, called a lateral. The physician will review the radiograph for signs of vertebral fracture or displacement. If damage is not evident, the physician will instruct the radiographer to remove the immobilization devices and proceed with the remainder of the radiographic examination. The stabilization devices are never to be removed until the spine is radiographically checked for damage and cleared for removal by the physician.
- When the radiographs were available for viewing, the radiographer noticed that the lower portion of the cervical spine was not well demonstrated. You will learn that when doing cervical spine trauma radiography, all of the vertebrae must be demonstrated. You should be able to see on the image on the slide that only 4 of 7 cervical vertebra are clearly visible. Notice that only a part of C5 is seen, and C6 & 7 are not visible at all.
- When the radiographer presented the physician with the radiographs for review, she said nothing about the lower portion of the spine being inadequately visualized. The physician wanted to see the spine better, and the conversation probably went something like this: Physician: I need a better look at the lateral, can you do anything differently? Radiographer: I can get a better view if he can sit up or stand up. Physician: He doesn’t seem to have any other injuries that would prevent him from moving into the upright position, so go ahead.
- The radiographer returned to the radiology department, had the patient stand up, and obtained a much better lateral radiograph. She was, in fact, able to show all 7 cervical vertebrae this time.
- But twenty minutes later a once mobile patient was paralyzed from the neck down, for life. So what happened here? The area not visualized on the first lateral projection had major damage – it just couldn’t be seen. When the cervical collar was removed, the neck was no longer stabilized. The unstable spine changed position as the patient moved, damaged the spinal cord at the site of injury, and a major paralytic event occurred On the slide you can see a typical lower cervical spine injury – one vertebra displaced over another, called subluxation. And if you think this lateral cervical looks different from the earlier image, you’re right. This image was obtained using a modality called magnetic resonance imaging, or MRI for short. The original image was done via conventional methods of radiography.
- Well, does the patient in this case study need an attorney? Answer these questions: If yes, what would be the basis of his case, and, where would you place the blame for the patient’s injury? If you don’t think he has a case, justify your answer. Please combine this assignment with the assignment in Lesson 3C. Submit your opinions to me by the deadline posted on the Calendar, and use the Submit Assignments tool in the course Library to send your opinions to me.
- Well, does the patient in this case study need an attorney? Answer these questions: If yes, what would be the basis of his case, and, where would you place the blame for the patient’s injury? If you don’t think he has a case, justify your answer. Please combine this assignment with the assignment in Lesson 3C. Submit your opinions to me by the deadline posted on the Calendar, and use the Submit Assignments tool in the course Library to send your opinions to me.
- Well, does the patient in this case study need an attorney? Answer these questions: If yes, what would be the basis of his case, and, where would you place the blame for the patient’s injury? If you don’t think he has a case, justify your answer. Please combine this assignment with the assignment in Lesson 3C. Submit your opinions to me by the deadline posted on the Calendar, and use the Submit Assignments tool in the course Library to send your opinions to me.