IHP420 Final.docx - Running head ITURRALDE V HILO MEDICAL...

Running head: ITURRALDE V. HILO MEDICAL CENTER USA ANALYSIS 1
Jessica Webber
Southern New Hampshire University
IHP-420 Ethical & Legal Considerations
Professor Catherine VonGarlem
April 20, 2018

ITURRALDE V. HILO MEDICAL CENTER USA ANALYSIS 2
In the case of Iturralde v. Hilo Medical Center USA, the plaintiff is Rosalinda Iturralde
who was acting on behalf of the patient, Arturo Iturralde’s estate and the defendants included Dr.
Robert Ricketson and the Hilo Medical Center USA. Rosalinda Iturralde was Arturo’s younger
sister and caregiver and sued on behalf of Arturo Iturralde because of his passing. The beginning
of Arturo’s care at Hilo Medical Center USA was in January 24
th
, 2001 and the final decision, in
favor of Rosalinda, wasn’t made until September 10 th , 2007.
This case started all because Arturo Iturralde needed a spinal fusion that was to be done
by Dr. Ricketson at the Hilo Medical Center USA on January 29, 2001. In summary, the hospital
had to order the kit for Arturo’s surgery and once the kit arrived at the hospital, no inventory was
taken of the kit which happens to be hospital policy. The surgery was started without the
inventory and only after Dr. Ricketson had already removed part of Arturo’s spine, was he
informed that the rods needed for the surgery were missing. He improvised and instead of using
the correct titanium rods, he implanted a section from a surgical screwdriver shaft that had come
in the kit. Dr. Ricketson, nor the hospital told Arturo or Rosalinda what had happened. Arturo
started physical therapy following surgery and the following day, likely due to one or more falls,
the screwdriver shaft shattered. Arturo was operated on again on February 5 th , 2001 to remove
the screwdriver and implant the correct rods. Following that surgery, Arturo was released, and his
health continued to go downhill. He required regular catheterization, became depressed, was
often in great pain, and reportedly lost his will to keep going. The rods eventually became
dislodged and Arturo needed two additional surgeries and rehabilitation. Following all of this, his
condition continued to get worse – he ended up undergoing permanent catheterization and
suffered from bouts of urosepsis which resulted in multiple hospitalizations and ER visits. He

ITURRALDE V. HILO MEDICAL CENTER USA ANALYSIS 3
eventually became completely bedridden and passed away from complications of urosepsis on
June 18
th
, 2003.
The court is deciding a question of both fact and law for this case. Dr. Ricketson
implanted a screwdriver shaft that was not approved for human implantation, which is
malpractice. The fact that Dr. Ricketson and the hospital didn’t follow hospital policy and
conduct an inventory on the kit when it arrived, was negligence. If inventory had been conducted
when the kit arrived, the missing titanium rods would have been discovered prior to the surgery.