Final Project: Final Project 1 Submission Jennifer D Coleman Southern New Hampshire University IHP-420 Ethical & Legal Considerations June 21, 2019
Introduction The case study presented is ITURRALDE v. HILO MEDICAL CENTER USA. In this case, the plaintiff is Rosalinda Iturralde, the sister of the deceased patient, is representing the Estate of Arturo Iturralde. 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 reported to HMC in January of 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 could potentially be relieved with a spinal fusion surgery. Under the direction of Dr. Ricketson, the surgery was scheduled for Monday January 29, 2001. The HMC ordered an M8 Titanium CD Horizon Kit from Medtronic which included all the necessary tools for the surgery including two titanium implant rods that were vital for the surgery. Medtronic sent the kits in two shipments, one from Memphis and the other came from Tulane. The shipments arrived to HMC on Saturday, January 27, 2001. The HMC staff didn’t complete an inventory of the contents of the package as they are supposed to do in accordance with their policy. Knowing that the Kit hadn’t been inventoried, an operating room was booked, and the available contents were prepped for surgery. Prior to the surgery, nurse Vicky Barry, informed Dr. Ricketson that an inventory of the Kit was not completed. Dr. Ricketson chose to proceed with the surgery, which is baffling. Over two hours into the surgery, when it became time to implant the titanium rods, the staff notified Dr. Ricketson that they could not locate the rods. The staff searched the hospital for the rods and
were unsuccessful in locating them. The staff then contacted a Medtronic sales representative, Eric Hanson and he offered to bring the implant rods to the hospital within 90 minutes. Dr. Ricketson states that he believed that the delay was too risky for the patient and proceeded to improvise the surgery and use a 3-4 cm piece of a surgical stainless-steel screwdriver in place of the titanium rods. He implanted the improvised section of the screwdriver into patient’s spine. Dr. Ricketson and the HMC staff failed to notify Arturo or his family that a screwdriver shaft was implanted in his spine rather than the titanium rods that he was told he would receive. Post- operative instructions were given by Dr. Ricketson that Mr. Arturo should be walking and undergoing physical therapy. The following day, Arturo sustained multiple falls, and this caused the screwdriver shaft to shatter. Dr. Ricketson preformed another surgery on Arturo on February
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