IHP 420 Final Project I Malpractice Case.docx - 1 Running...

Running head: FINAL PROJECT I
Final Project I: Malpractice Case
Southern New Hampshire University
October 17, 2018
1

FINAL PROJECT I
Introduction
In the case of Iturralde v. Hilo Medical Center (HMC), USA., describes a situation where
the decedent Arturo Iturralde was admitted to HMC in January of 2001 for increasing leg pain
and weakness which had resulted in several falls. On January 24
th
, orthopedic surgeon Robert
Ricketson, M.D. examined Arturo and diagnosed him with degenerative spondylolisthesis L4-L5
and scheduled him for spinal fusion surgery at HMC. Dr. Ricketson ordered the hardware kit to
include all instrumentation and tools needed to perform the surgery from Medtronic
(FindLaw.com, 2012). Medtronic did not have the instrumentation portion of the kit in stock at
their facility in Memphis so they sent the order to HMC in two shipments, one from Memphis
and the other from Tulane. Both shipments were received on the same day at HMC. Per HMC
policy, a complete inventory of the contents in the kit are to be completed prior to surgery. The
inventory of the kit failed to be conducted by HMC staff. Nurse Vicki Barry informed Dr.
Ricketson that the inventory of the kit was not completed. However, Dr. Ricketson decided to
proceed with the surgery without the contents of the kit being inventoried. During the surgery, it
was discovered that both titanium rods were not available. Staff contacted the sales rep from
Medtronic and the soonest they could deliver implant rods were ninety minutes. Dr. Ricketson
felt the delay was too risky and decided to proceed with the surgery without the rods. He then
created a rod from the stainless-steel screwdriver shaft and implanted it into Arturo’s spine,
creating an improvised unilateral rod. The patient was never informed the incident that occurred
and was ordered physical therapy post-operatively, along with walking. The following day,
Arturo sustained a fall(s) and the screwdriver shaft shattered in his back. Dr. Ricketson operated
again on the patient and removed the shattered pieces and added the proper titanium rods in
place. The nurse who had been present in the initial surgery was aware that the doctor did not

FINAL PROJECT I
inform the patient of what had happened so she tried to inform the patient but the patient did not
speak English. The nurse obtained the shattered screwdriver shaft and delivered it to an
attorney’s office and then called the patient’s sister and caretaker, Rosalinda, to inform her of
what occurred. Rosalinda informed her brother of the incident. After Arturo was discharged his
condition continued to worsen. He was unable to care for himself, and required assistance with
personal care and catherization, along with great pain and ultimately, he became depressed.