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1MILESTONE ONEFinal Project I: Milestone One: Malpractice CaseElizabeth HollandSouthern New Hampshire University
2MILESTONE ONEIntroductionThe case study presented is ITURRALDE v. HILO MEDICAL CENTER USA. In this case, the plaintiff is Rosalinda Iturralde who is representing the Estate of Arturo Iturralde, who isher brother. The defendants are the Hilo Medical Center (HMC), Dr. Robert Ricketson, and Medtronic Sofamor Danek USA, Inc. The plaintiff, Rosalinda Iturralde is suing Hilo Medical Center, Hawaii Orthopaedics, Inc., Dr. Ricketson, and Medtronic Sofamor Danek USA, Inc. for medical malpractice and negligence that led to the death of her brother Arturo Iturralde. Arturo Iturralde was admitted to HMC in January 2001 for an assessment following several falls due to increasing weakness in his legs. Dr. Ricketson, an orthopedic surgeon, assessed Arturo on January 24, 2001 and diagnosed him with degenerative spondylolisthesis L4-5 with stenosis. This condition was exerting pressure on his nerves and it could potentially be relieved with a spinal fusion surgery. The surgery was then scheduled for Monday January 29, 2001. Directed by Dr. Ricketson, HMC ordered an M8 Titanium CD Horizon Kit from Medtronic which included all the necessary tools for the surgery including two titanium implant rods. Medtronic sent the kits in two shipments, one from Memphis and another from Tulane. The shipments were both received on Saturday, January 27, 2001. The HMC staff did not complete an inventory of the contents of the Kit in accordance with their policy. Even though the tools in the Kit were not inventoried, the contents were sterilized and sent to the operating room. Prior to the surgery, a nurse Vicky Barry, informed Dr. Ricketson that an inventory of the kit was not completed. Yet, Dr. Ricketson chose to proceed with the surgery. A little over two hours into the surgery, when the time came to implant the titanium rods, the staff notified Dr. Ricketson that they could not locate the rods. After searching the hospital for the rods and not locating them, staff contacted the Medtronic sales representative, Eric Hanson. He offered to
3MILESTONE ONEbring the implant rods to the hospital within 90 minutes. Dr. Ricketson believed that the delay was too risky for the patient. He proceeded with the surgery and improvised a surgical stainless-steel screwdriver to implant in place of the titanium rods. He implanted the improvised screwdriver into Arturo’s spine which created a unilateral rod. Dr. Ricketson and the HMC staff failed to notify Arturo that a screwdriver shaft was implanted in his spine rather than the titaniumrods. Post-operative instructions were given by Dr. Ricketson for walking and physical therapy for Arturo. The next day, Arturo sustained at least one fall if not more causing the screwdriver shaft in his spine to shatter. Dr. Ricketson preformed another surgery on Arturo on February 5, 2001 to remove the screwdriver pieces and implant the proper titanium rods. A nurse, Janelle