The nurse recovered the pieces of the screwdriver

was unable to communicate the substitution made during the procedure due to a language barrier.
The nurse recovered the pieces of the screwdriver removed during the second surgery. She
brought the pieces to an attorney who was able to reach Arturo’s sister, Rosalinda, and informed
her of what had happened during her brother’s operations.
Arturo was discharged from HMC. He underwent two more revision surgeries the next
two years in Honolulu. His condition steadily deteriorated, resulting in declined mental and
physical conditions. He developed urosepsis (infection of the urinary tract) from permanent
catheterization and was hospitalized multiple times. He became bedridden and passed away on
June 18, 2003, from complications of urosepsis ("FindLaw for legal professionals," n.d.)
This is clearly a case of negligence. Replacing titanium spinal rods with a screwdriver
shaft is intentional misuse. Healthcare professionals are expected to use “reasonable skill” when
providing care to patients. Dr. Ricketson’s actions were outside the scope of standard of care.

4
MALPRACTICE CASE ITURRALDE V. HILO MEDICAL CENTER
The standard is set by observing what a competent peer or physician would do, if in the same
situation. Standard of care is the minimal level set (Fremgen, 2016 ).
Dr. Ricketson had a history of serious professional problems and had been placed on
disciplinary orders for numerous lapses in judgement, falsifying medical record, violating drug
laws, writing false prescriptions, lying to licensing authorities, and failing to report prior actions
against his license.  HMC continued to award him hospital privileges.  Dr. Ricketson and HMC