CASE STUDY WEEK 9
CASE STUDY ASSIGNMENT
- READINGS: Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Jones and Bartlett Publishers.
- Joel, L. A. (2018). Advanced practice nursing: Essentials for role development (4th ed). F .A. Davis Company.
Purpose:The purpose of this paper is to foster your synthesis of course content relevant to medical liability concepts. You should complete the learning materials before completing the case as important background information will be included in these resources.
Process:A rubric is provided to assist in communicating the expectations for this assignment. The questions within each case study are designed to direct the focus of your paper. Reference the paper where appropriate, especially in the discussion about the standard of care.
CASE STUDY
ABOUT THE PATIENT
Name: Rafael
Age: 31
Gender: Male
Other details: Family history of cancer
VISITS
1October 2001
Rafael was seen by the nurse practitioner with complaints of abdominal burning and cramping, abdominal pain and inability to eat for a few weeks, but incidentally resolved as of the appointment. The nurse practitioner prescribed Zantac and set up a complete physician exam for the next month.
2November 2001
During this visit the patient gave a history of chewing tobacco and heavy coffee intake, occasional abdominal pain and increased in stool frequency. Rafael also indicated a family history that his mother was diagnosed with colon cancer at the age of 54. The nurse practitioner changed the medication regimen from Zantac to Protonix and ordered an upper GI series with contrast to rule out gastritis or an ulcer. The negative test results were provided to the primary care physician, who never saw the patient or reviewed the patients chart.
3December 2001
The patient was seen by the nurse practitioner a month later, when he reported that his symptoms were improved on Protonix, but he continued to have problems with eating. The nurse practitioner continued with a diagnosis of gastritis and gave instructions to call with any concerns and scheduled a follow-up visit in six months.
4April 2002
Rafael returned and reported worsening stomach cramps and burning to the nurse practitioner. The nurse practitioner then changed the medication to Prevacid, continued with a diagnosis of gastritis and arranged for an appointment with a gastroenterologist for a possible esophagogastroduodenscopy in July.
5May 2002
Rafael returned for an appointment with the MD, complaining of increasing pain and loose stools. The appointment for a GI consult was moved up after a discussion with the physician, but Rafael went to an emergency room before the scheduled visit. A work-up at the hospital, which included an abdominal CT scan and colonoscopy, resulted in a diagnosis of near obstruction of the right side of the colon by a Stage IV tumor and metastasis to the peritoneum and lymph nodes.
TREATMENTS
Immediate surgery was performed, followed by chemotherapy, and more. Rafael died about two years later, in December 2004.
REVIEW THE CASE
Please review the listed questions and answer in the paper answering each question as a sub heading.
- 1-Identify the defendants and the areas of negligence in this case.
- 2-Given the patient’s symptoms listed above, provide a comprehensive differential diagnoses list (ONLY a list).
- 3-Reflect on this case and what you would have done differently as an advanced practice registered nurse.
- 4-Review the risks that NPs face associated with practice identified in Buppert (2018) p. 289 and identify which of these apply to the case. What strategies might have reduced the risk of the outcome presented in this case? Refer to Buppert (2018) Chapter 8: Risk Management.
- 5-What do you think the verdict was and why?
